Return to flip book view

CapnoTrainer P6.0 Operating Manual

Page 1

The Capnotrainer Management SystemThe Capnotrainer Management SystemOwner Operating ManualOwner Operating Manual TMTM

Download

Support

Page 2

OWNER OPERATING MANUAL The CapnoTrainer Management System™ TABLE OF CONTENTS Owner Operating Manual…………………………… ............................................................................................................................................ 1 Welcome to the CapnoTrainer Management System™ ............................................................................................................................. 5 Download the CapnoTrainer Management System™ software ................................................................................................................. 5 A. First Time CapnoTrainer® P6.0 Customers ........................................................................................................................................ 5 B. Additional new P6.0 instruments for P6.0 Customers ...................................................................................................................... 5 C. First Time software subscribers with 5.0 or earlier CapnoTrainers® ................................................................................................. 6 D. Additional 5.0 or earlier instruments for 5.0 users ........................................................................................................................... 6 E. Users who are mixing 5.0 (or earlier) and P6.0 instruments ............................................................................................................. 6 COMPLETE THE USER (Admin) PROFILE ..................................................................................................................................................... 6 Learn how to use the ADMIN COMPUTER Dashboard............................................................................................................................... 7 Learn how to use ADMIN CLOUD Dashboard ............................................................................................................................................ 7 Learn about Client and Associate Trainer Dashboards .............................................................................................................................. 7 LOG IN SCREEN…………………………………………………………………………………………………………………………………………………………………………………..10 Menu Bar………………………………………………………………………………………………………………………………………………………………………………………10 Main Menu……………………………………………………………………………………………………………………………………………………………………………………10 Tech Support…………………………………………………………………………………………………………………………………………………………………………………10 Working Offline……………………………………………………………………………………………………………………………………………………………………………..10 LIVE SESSIONS - Sidebar ........................................................................................................................................................................... 12 Proceed without a Client name ........................................................................................................................................................... 12 Choose a Client and proceed ............................................................................................................................................................... 12 Enter New Client and proceed ............................................................................................................................................................. 12 Run a Group Session ............................................................................................................................................................................ 12 CLOUD DASHBOARD - Sidebar ................................................................................................................................................................. 12 Manage Software Subscription ........................................................................................................................................................... 13 GROUPS - Sidebar .................................................................................................................................................................................... 13 Add a new Group ................................................................................................................................................................................. 13 Edit a Group Profile ............................................................................................................................................................................. 14 ASSOCIATE TRAINERS – Sidebar ............................................................................................................................................................... 14 Add a new Associate Trainer ............................................................................................................................................................... 14 Edit an Associate Trainer Profile .......................................................................................................................................................... 14 CLIENTS - Sidebar ..................................................................................................................................................................................... 15 Add a new Client .................................................................................................................................................................................. 15 Edit a Client Profile .............................................................................................................................................................................. 15 MY PROFILES - Sidebar ............................................................................................................................................................................. 15 Personal Profile .................................................................................................................................................................................... 16 Hardware Profile .................................................................................................................................................................................. 16 SUBSCRIPTION MANAGEMENT - Sidebar ................................................................................................................................................. 16 Auto-update ........................................................................................................................................................................................ 16 Auto-subscription ................................................................................................................................................................................ 16 LOGOUT - Sidebar .................................................................................................................................................................................... 16 PERSONAL DASHBOARD........................................................................................................................................................................... 16 CLIENT COMPUTER DASHBOARD ............................................................................................................................................................. 16 MAIN MENU BAR ..................................................................................................................................................................................... 17 Right side of MAIN MENU BAR: Information ....................................................................................................................................... 17 Left side of MAIN MENU BAR: Action Options .................................................................................................................................... 17 Physiology ............................................................................................................................................................................................ 17 Hardware ............................................................................................................................................................................................. 17 Data ..................................................................................................................................................................................................... 17 Clients .................................................................................................................................................................................................. 17 Images ................................................................................................................................................................................................. 17 Notes ................................................................................................................................................................................................... 18 Groups ................................................................................................................................................................................................. 18 Help...................................................................................................................................................................................................... 18

Page 3

SCREEN CONTROLS BAR – LEFT SIDE: Indicator and Adjustment icons ................................................................................................... 18 SCREEN CONTROLS BAR – RIGHT SIDE: Action Options .......................................................................................................................... 18 Connect capnotrainer® ................................................................................................................................................................... 18 Pause/unpause data record ............................................................................................................................................................ 19 Choose task (sub-sessions) .............................................................................................................................................................. 19 Choose history graphs ..................................................................................................................................................................... 19 Choose configuration ...................................................................................................................................................................... 19 Save alt configuration ..................................................................................................................................................................... 19 Freeze/unfreeze screen .................................................................................................................................................................. 19 Clear screen ..................................................................................................................................................................................... 19 Take a picture .................................................................................................................................................................................. 19 Mute volume ................................................................................................................................................................................... 19 Increase font size ............................................................................................................................................................................ 20 Decrease font size ........................................................................................................................................................................... 20 OBSERVABLE AND RECORDABLE SIGNALS ............................................................................................................................................... 20 Breathing physiology ........................................................................................................................................................................... 20 Cardiac physiology ............................................................................................................................................................................... 20 Algorithmic breathing signals .............................................................................................................................................................. 20 PetCO2 mmHg ................................................................................................................................................................................. 20 Capnia Index mmHg ........................................................................................................................................................................ 20 Breaths/Min .................................................................................................................................................................................... 20 Br-holds/Min ................................................................................................................................................................................... 20 Gasps/Min ....................................................................................................................................................................................... 20 Aborted-Exhales/Min ...................................................................................................................................................................... 20 Relative-Volume/Min ...................................................................................................................................................................... 20 DISPLAY OPTIONS BAR ............................................................................................................................................................................. 21 1. PCO2 Waveform ............................................................................................................................................................................... 21 2. End-tidal CO2 (PetCO2) ..................................................................................................................................................................... 21 3. Capnia Index .................................................................................................................................................................................... 21 4. Feedback Screens ............................................................................................................................................................................ 21 5. Breathing Mechanics ....................................................................................................................................................................... 22 6. Breathing Testing ............................................................................................................................................................................. 22 Breathing template settings ............................................................................................................................................................ 22 X-axis Range ................................................................................................................................................................................ 22 Breaths per minute ..................................................................................................................................................................... 22 Time for One Breath ................................................................................................................................................................... 22 Exhale Time ................................................................................................................................................................................. 22 Inhale Time ................................................................................................................................................................................. 23 Transition Time ........................................................................................................................................................................... 23 Marker Type ................................................................................................................................................................................ 23 Challenge 1: faces & markers ......................................................................................................................................................... 23 Facial expressions ....................................................................................................................................................................... 23 Challenge 2: exhalation-inhalation transition time ......................................................................................................................... 23 Challenge 3: breathing rate challenge ............................................................................................................................................ 24 Choose number of different Testing Rates ................................................................................................................................. 24 Set a Time Period for Rates......................................................................................................................................................... 24 Choose a Marker Type ................................................................................................................................................................ 24 Set a Breathing Rate for each Testing Rate ................................................................................................................................ 24 Stop challenge: ................................................................................................................................................................................ 24 Collapse template ........................................................................................................................................................................... 24 Expand ............................................................................................................................................................................................. 24 7. HRV, RSA & HR ................................................................................................................................................................................. 25 8. HRV – Time Analysis......................................................................................................................................................................... 25 9. HRV – FFT ......................................................................................................................................................................................... 25 10. Animated Feedback ....................................................................................................................................................................... 26 11. Groups ........................................................................................................................................................................................... 26

Page 4

SIGNAL CONTROLS BAR ........................................................................................................................................................................... 26 X-axis range ..................................................................................................................................................................................... 27 Units ................................................................................................................................................................................................ 27 Show annotations ........................................................................................................................................................................... 27 Show grid lines ................................................................................................................................................................................ 27 Invert y-axis ..................................................................................................................................................................................... 27 Min/max y-axis ................................................................................................................................................................................ 27 Auto-offset (HRV only) .................................................................................................................................................................... 27 Y-axis position ................................................................................................................................................................................. 27 Signal Settings ...................................................................................................................................................................................... 27 Moving averages ............................................................................................................................................................................. 27 Edit algorithm .................................................................................................................................................................................. 27 Breath-hold/minute .................................................................................................................................................................... 27 PetCO2 ......................................................................................................................................................................................... 27 Breaths/minute ........................................................................................................................................................................... 27 Hide signal ....................................................................................................................................................................................... 27 Show peak marker........................................................................................................................................................................... 27 Signal type ....................................................................................................................................................................................... 27 Type of line ...................................................................................................................................................................................... 28 Line width ........................................................................................................................................................................................ 28 Sample point size ............................................................................................................................................................................ 28 Color ................................................................................................................................................................................................ 28 Threshold Settings ............................................................................................................................................................................... 28 Value ............................................................................................................................................................................................... 28 Note ................................................................................................................................................................................................. 28 Hide threshold ................................................................................................................................................................................. 28 Line width ........................................................................................................................................................................................ 28 Type of line ...................................................................................................................................................................................... 28 Color ................................................................................................................................................................................................ 28 Name BAR Settings .............................................................................................................................................................................. 28 Corollary BAR Settings ......................................................................................................................................................................... 28 Auditory Feedback Settings ................................................................................................................................................................. 28 Visual Feedback Settings ..................................................................................................................................................................... 29 Expand Screen ..................................................................................................................................................................................... 29 DISPLAY CONTROLS BAR .......................................................................................................................................................................... 29 Collapse screen .................................................................................................................................................................................... 29 Full Screen ........................................................................................................................................................................................... 29 Annotate, show data points ................................................................................................................................................................ 29 Zoom in ................................................................................................................................................................................................ 29 Zoom out ............................................................................................................................................................................................. 29 Take Picture ......................................................................................................................................................................................... 30 Pan Live History ................................................................................................................................................................................... 30 INITIAL STEPS ........................................................................................................................................................................................... 31 CREATE DATA REPORTS ........................................................................................................................................................................... 31 Create & Save a Session Data Report .................................................................................................................................................. 32 Create & Save a Multisession Report .................................................................................................................................................. 32 Create and Save a Group Session Report ............................................................................................................................................ 32 PRACTICE: Creating Data Reports (demo data only) ........................................................................................................................... 33 VIEW & EDIT DATA REPORTS ................................................................................................................................................................... 33 VIEW PDF REPORTS .................................................................................................................................................................................. 33 VIEW LIVE SESSION INFORMATION ......................................................................................................................................................... 33 VIEW/MANAGE FORMS ........................................................................................................................................................................... 34 Download Fill-in PDF Blank Forms ....................................................................................................................................................... 34 Upload Completed Client Forms .......................................................................................................................................................... 34 Upload Completed Trainer Forms ....................................................................................................................................................... 34 View Completed Client Forms ............................................................................................................................................................. 35 View Completed Trainer Forms ........................................................................................................................................................... 35 View Completed Homework Assignment Forms ................................................................................................................................. 35

Page 5

VIEW, CREATE, EDIT PROFILES ................................................................................................................................................................. 35 SESSION REPORT ASSEMBLY .................................................................................................................................................................... 36 SUBSCRIPTION MANAGEMENT ................................................................................................................................................................ 36 LOG OUT .................................................................................................................................................................................................. 36 CREATE & SAVE A SESSION DATA REPORT ............................................................................................................................................... 37 Preconfigurations ................................................................................................................................................................................ 37 Report option 1: Raw PCO2, with PetCO2 and breaths/min histories ............................................................................................ 37 Report option 2: PetCO2 breath to breath, with PetCO2 and breaths/min histories ..................................................................... 37 Report option 3: Capnia Index breath to breath, with PetCO2 & breaths/min histories ............................................................... 37 Report option 4: Breathing Mechanics: gasping, aborted breaths, breathholding, relative volume, breaths/min histories ........ 37 Report option 5: Breathing Chemistry: PetCO2 and capnia index histories ................................................................................... 37 Report option 6: All breathing signal histories ............................................................................................................................... 37 Report option 7: Beat to beat heart rate and raw PCO2, with heart rate, RSA, & breaths/min histories ...................................... 38 Report option 8: RSA beat to beat amplitudes, with PetCO2, heart rate, RSA, & breaths/min histories ....................................... 38 Report option 9: All Histories ......................................................................................................................................................... 38 Report option 10: Tachograph of RR-interval with time and frequency domain HRV components……………………………………………38 Main Menu Bar .................................................................................................................................................................................... 38 Action options ................................................................................................................................................................................. 38 Export Data ................................................................................................................................................................................. 38 Take Notes .................................................................................................................................................................................. 38 Make PDF .................................................................................................................................................................................... 38 Save Alt Configuration ................................................................................................................................................................ 38 Save Report ................................................................................................................................................................................. 38 Viewing options ............................................................................................................................................................................... 38 View/Hide Session Notes ............................................................................................................................................................ 38 View Session Images ................................................................................................................................................................... 38 View Session Zoom Recording .................................................................................................................................................... 38 View PDF of Last Session............................................................................................................................................................. 38 View/Hide All Tables ................................................................................................................................................................... 38 Client, trainer, session info.............................................................................................................................................................. 38 Return to dashboard ....................................................................................................................................................................... 38 Creating multiple reports in the same session ................................................................................................................................ 39 Alternative preconfiguration ........................................................................................................................................................... 39 Multiple data records ...................................................................................................................................................................... 39 Graph Features .................................................................................................................................................................................... 39 Graph labeling ................................................................................................................................................................................. 39 Y-axis icon ........................................................................................................................................................................................ 39 X-axis icon........................................................................................................................................................................................ 39 Zooming in/out................................................................................................................................................................................ 39 Signal values .................................................................................................................................................................................... 39 Report annotations ......................................................................................................................................................................... 39 Task-sessions ................................................................................................................................................................................... 39 Session annotations ........................................................................................................................................................................ 39 Data pauses ..................................................................................................................................................................................... 39 Signal Controls Bar: .............................................................................................................................................................................. 39 Graph Controls Bar .............................................................................................................................................................................. 39 CREATE & SAVE A MULTI-SESSION DATA REPORT ................................................................................................................................... 40 Main Menu Bar .................................................................................................................................................................................... 40 Action icons for multi-session reports ............................................................................................................................................ 40 Configure graph linking ................................................................................................................................................................... 40 Viewing icons for multisession reports ........................................................................................................................................... 40 Graph Controls Bar .............................................................................................................................................................................. 40 Signal Controls Bar ............................................................................................................................................................................... 40 CREATE & SAVE A GROUP REPORT .......................................................................................................................................................... 41 Main Menu Bar .................................................................................................................................................................................... 41 Graph Controls Bar .............................................................................................................................................................................. 41 Signal Controls Bar ............................................................................................................................................................................... 41 Email: tech@betterphysiology.com Tel: 307.773.0888

Page 6

Owner Operating Manual TThhee CCaappnnooTTrraaiinneerr MMaannaaggeemmeenntt SSyysstteemm™™ Live Physiology, Recorded Data, and Reports Welcome to the CapnoTrainer Management System™. The CapnoTrainer Management System™ is an annual subscription program that provides users with training and learning tools for exploring, identifying, unlearning, and learning breathing habits. It provides the tools for personalized breathing education based on the principles of behavioral analysis through the presentation of both live and recorded data. The CapnoTrainer Management System™ nor the CapnoTrainer® are intended for diagnostic, treatment, or healthcare management purposes. Download the CapnoTrainer Management System™ software. The software can be installed on both PC and Apple MAC computers. Older instruments (5.0 and before) CANNOT be used on Apple computers. A. First Time CapnoTrainer® P6.0 Customers B. Additional new P6.0 instruments for P6.0 Customers C. First Time software subscribers with 5.0 or earlier CapnoTrainers® D. Additional 5.0 or earlier instruments for 5.0 users E. Users who are mixing 5.0 (or earlier) and P6.0 instruments A. First Time CapnoTrainer® P6.0 Customers 1. Go to https://betterphysiology.com/download-p6-0/. 2. Click on DOWNLOAD P6.0 Software. 3. Enter the serial number(s) located on back of the instrument(s). 4. Enter your email address (username). 5. Create a Password for your new Cloud account. 6. Click on CONTINUE Download. The serial number will be verified when you click on CONTINUE Download. If the serial number is not found a mismatch message will appear. If so, contact the distributor/salesperson from whom the instrument was purchased. Your personal Customer CLOUD DATABASE ACCOUNT has now been created. Now do the following: 1. Install the software by clicking on the CapnoTrainer-Setup file that will appear in your browser. 2. Move the switch on your instrument to the USB position and connect your instrument to a USB port. 3. Click on the CapnoTrainer® icon on the computer desktop. 4. Enter your email (username) and Password. 5. Complete your USER (admin) PROFILE to configure the software for your needs. 6. Click on LIVE SESSIONS. Click on the CONNECT CAPNOTRAINER icon and REGISTER the instrument by entering its Serial Number when prompted, as shown below, and thus connecting it with its Internal ID. NOTE: The internal ID of the device and your profile information is uploaded to the Customer Cloud Account. Whenever the instrument is plugged in, whether your computer is connected to the Internet or not, is identified by its internal ID. YOU ARE READY TO GO! Subsequent downloads of the software: Users may download the software from the BP website at any time, on any computer, by going to https://betterphysiology.com/download-p6-0/. Simply enter your email address (username) and Password. Logging into Customer Cloud Account: There are three ways to log in: (1) Click on OPEN CLOUD DATABASE in the initial login dialog box. (2) Click on CLOUD DATABASE on the COMPUTER DASHBOARD after logging into the software. (3) Go to https://www.capnoLearning.com and enter your email (username) and Password. B. Additional new P6.0 instruments for P6.0 Customers Register each additional instrument by taking these steps: 1. Make sure that the computer is connected to the Internet. 2. Plug in your additional instrument to a USB port and log into the CapnoTrainer software. 5

Page 7

3. Go to your Computer Dashboard and click on LIVE SESSIONS. 4. Click on the CONNECT CAPNOTRAINER icon to start up the additional instrument. 5. Enter the Serial Number of the additional instrument when prompted in the next dialog box that appears; see next page. YOU ARE READY TO GO! Groupwork: When choosing to do groupwork, a GROUP PROFILE must be created where serial numbers of all registered instruments will appear for assignment to specific Clients. If an instrument has not been previously registered, it will need to be plugged in at that time and identified as described above. C. First Time software subscribers with 5.0 or earlier CapnoTrainers® 1. Go to https://betterphysiology.com/shopping-cart/. 2. Purchase the software. You cannot download the software without doing so. 3. Click on DOWNLOAD P6.0 Software on the page that will appear immediately after making payment. 4. Enter the serial number(s) located on back of the instrument(s), when prompted. 5. Enter your email address (username) when prompted. 6. Create a Password for your new Cloud Account. 7. Click on CONTINUE Download. The Customer CLOUD DATABASE ACCOUNT has now been created. 1. Plug an instrument into the computer. It will be identified as a 5.0 (or earlier) device. 2. Click on the CapnoTrainer® icon on the computer desktop. 3. Enter your email address (username) and Password. 4. Complete your USER (admin) PROFILE to configure the software for your needs. 5. Click on LIVE SESSIONS. Click on the CONNECT CAPNOTRAINER icon and REGISTER the instrument by entering its Serial Number when prompted, as shown in the page above. Note: The profile and serial number are auto-uploaded to the Customer CLOUD DATABASE account. YOU ARE READY TO GO! Subsequent downloads of the software: Users may download the software from the BP website at any time, on any computer, by going to https://betterphysiology.com/download-p6-0/. Simply enter your email address (username) and Password. Logging into Customer Cloud Account: There are three ways to log in: (1) Click on CLOUD DATABASE on the COMPUTER DASHBOARD after logging into the software. (2) Click on OPEN CLOUD DATABASE in the initial login dialog box. (3) Go to https://www.capnoLearning.com and enter your email (username) and Password. D. Additional 5.0 or earlier instruments for 5.0 users Register additional 5.0 (or earlier) instruments in one of two ways: 1. Go to the Hardware Profile page on the Computer or Cloud Dashboard to add additional instruments and serial numbers. 2. When setting up instruments for Groupwork, enter the serial numbers to be associated with each Client. E. Users who are mixing 5.0 (or earlier) and P6.0 instruments The software system will auto-identify the kind of hardware being plugged in, P6.0 or 5.0 (or before). It is NOT possible to mix hardware types in doing groupwork. The user will be required to specify the hardware type to be used (P6.0 or 5.0) in creating a GROUP PROFILE. COMPLETE THE USER (Admin) PROFILE: Choose the intended use of the CapnoTrainer Management System™. The System is designed for: (1) Personal use (no Clients), (2) Single-user professional use for those providing learning services for Clients, (3) Multi-user professional use for organizations providing learning services to clients, and (4) Groupwork where multiple CapnoTrainers® can be run simultaneously on the same computer. 6

Page 8

Complete the ADMIN profile and indicate the intended use(s) of the CapnoTrainer® breathing learning system. The intended uses may be edited at any time on both the COMPUTER and CLOUD DASHBOARDS. The following options will appear: YES □ NO □ I will be working with Clients. YES □ NO □ I have Associate Trainers who will be providing learning services using my System. YES □ NO □ I will be doing groupwork with multiple CapnoTrainers®. YES □ NO □ I purchased the CapnoTrainer HRV P6.0 option. YES □ NO □ Auto-update Computer Software. Learn how to use the ADMIN COMPUTER Dashboard. Upon completion of the profile, the CapnoTrainer Management System™ will configure both the COMPUTER and CLOUD DASHBOARDS based on the profile selections made above. As the Subscriber to the System, the Customer is always ADMIN. In all cases, the Computer Dashboard will provide options to (1) engage LIVE physiology learning applications, (2) access the CLOUD DATABASE DASHBOARD, (3) edit the Customer (ADMIN) profile, including the associated profile setup options described above, and (4) manage the CapnoLearning System™ subscription options. Based on the profile, additional management options will appear on the COMPUTER DASHBOARD for seeing clients, working with Associate Trainers, and/or doing groupwork. These options include (1) engaging live physiology applications for specific Clients, (2) engaging live physiology for specific Groups, and (3) creating, editing, and viewing Client, Associate Trainer, and Group profiles. Learn how to use ADMIN CLOUD Dashboard. The Customer Cloud Dashboard account, based on Customer profile selections, will provide comprehensive database management options including creating, editing, linking, uploading, downloading, and/or viewing session data reports, multisession reports, fill-in PDF forms, profiles, live session notes, live session screen images (snapshots), and zoom recordings for ADMIN, Associate Trainers, and Clients. As a Subscriber to the System, the Customer is always ADMIN as well as a Trainer. Should a user become disconnected from the Internet, all session data, notes, images, and profile updates are stored in temporary files until reconnected and are then automatically uploaded into the Customer CLOUD DATABASE account. Session data, notes, and images are NOT available for viewing on the computer. Learn about Client and Associate Trainer Dashboards. Creating new Client and Associate Trainer profiles provides them with access to their own COMPUTER and CLOUD DASHBOARDS within the Customer CapnoTrainer Management System™ account. Upon creation of a new Client or Trainer profile on the Customer Dashboards, an automatic email goes out to the Client or Associate Trainer instructing them to download the software and create a password for entering the COMPUTER and CLOUD DASHBOARDS. This allows Associates Trainers to manage their own Clients by creating, editing, and/or viewing data reports, session notes and images, forms, Zoom recordings, and their own profiles. And, it allows Clients to view data reports and session records and to submit completed forms and homework assignments. 7

Page 9

LOG IN SCREEN The Log in dialog box provides important options besides logging into the physiology software. MENU BAR: This BAR is available on the log in Dialog Box AND within the the physiology software. 1. Click on OVERVIEW for a review of the System Software features. 2. Click on ORDER SUPPLIES for a direct link to the Shopping cat on the better Physiology Website. 3. Click on TECH SUPPORT for reporting bugs and for help. 4. Click on TUTORIALS for learning how to use your software. 5. Click on ZOOM IN/OUT to adjust the screen appearance. 6. Click on LANGUAGES (six) to view the screens in different languages, e.g., Japanese. 7. Click on ANNOUNCEMENTS for important information when you see PLEASE READ blinking. 8. Click on DEBUG when asked to do so by Tech Support. 9. Click on TESTING for problems with Water Traps and/or restarting your instrument. MAIN MENU: Enter your Email Address and Password. Click on SIGN-IN to access the Computer Dashboard. Click on OPEN Cloud Dashboard to access the Database. Click WORK OFFLINE if you cannot connect to the Internet, or if you wish to export the data instead of saving it to your Cloud Dashboard (from where you may also export the data). Data, pictures, and notes will be saved in a temporary file. Upon entering the software at a later time when connected to the Internet, you will be prompted to SYNC (or Sync Later) recorded offline sessions one at a time with the Cloud Database, or to discard them. You may sort sessions by client name or date by clicking on the arrow tab in front of either one. Click on READ OPERATING MANUAL to see the Manual. Click on CLOSE CapnoTrainer SOFTWARE to exit the dialog box. 8

Page 10

DESCRIPTIVE OVERVIEW The new P6.0 version of the CapnoTrainer, now in its 20th year, is the ultimate system for identifying breathing habits, learning to disengage dysfunctional breathing habits, and learning new breathing habits for improving health and performance. The CapnoTrainer Management System™ is a comprehensive integrative learning system, including: Instrument: Record breathing physiology with a wearable, battery-operated, Bluetooth device. Computer software: Observe, evaluate, teach, and learn breathing habits. Cloud database: Manage data, records, clients, and trainers. INSTRUMENT The CapnoTrainer® Management System P6.0 INSTRUMENT is wearable, with a customized vest for a wide range of educational applications. It is battery-operated (rechargeable) and Bluetooth-operated. You can monitor live physiology on up to six CapnoTrainers® simultaneously for doing group work on PC and Apple computers, and within a short time be able to wirelessly collect data on your cell phone, Android or I-phone. You may also USB connect your CapnoTrainer® to your computer for tabletop applications. Its modular hardware design permits you to self-service your CapnoTrainers® in the field, including calibration and replacing all primary hardware components. It operates with small water traps that block water from entering the instrument and shuts down automatically should you forget to change the trap. You may monitor raw PCO2 (waveform signal) and its associated seven algorithmic signals, along with the option of doing Heart Rate Variability that includes Beat to Beat Heart Rate and Breath to Breath Respiratory Sinus arrythmia (RSA) Amplitude signals. COMPUTER SOFTWARE The CapnoTrainer® Management System SOFTWARE, together with the CapnoTrainer® Management System CLOUD DATABASE, comprise a subscription program, renewable annually. Version 1.2.3 of the software operates on PC and Apple (MAC OS 10) computers and a new version of the software will operate with cell phones, including I-pads, on or before February 15. Updates are auto-installed, but can be managed manually if desired. Description of the live physiology software features is shown below. Observe, record, and manage up to 18 physiology signals. Learn about respiratory chemistry, breathing mechanics, and heart rate variability. Observe breathing mechanics based on unique airflow algorithms – 5 signals: Gasps/min, aborted breaths/min, breath-holds/min, breaths/min, relative volume. Edit some of the algorithms as per your own definitions, e.g., what is a breath? Observe live respiratory physiology, including two algorithmic signals – 3 signals: Raw PCO2, End-tidal PCO2 (PetCO2), and Capnia Index (mmHg below/over 35). Observe and record Heart Rate Variability (HRV), including nine algorithmic signals – 10 signals: Beat-to-Beat Heart Rate, Respiratory Sinus Arrythmia (RSA) Amplitude, RR Interval, Arousal, Parasympathetic Tone, Parasympathetic Reserve, FFT, HF, LF, and VLF. See multiple combinations of graphic & digital displays that include: Live CO2 signals: Raw PCO2, breath-to-breath PetCO2, Capnia Index. Live HR signals: beat-to-beat HR, RR interval, FFT Live history graphs: Turn ON/OFF sets of history graphs (0, 3, 6) in all breathing display options. Live history graphs: Turn ON/OFF history graph below Breathing Template displays (same for all options). Live history graphs: Turn ON/OFF history graphs below all HRV display options (different for each option). Corollary Physiology Bar: View digital presentation of algorithmic signal values. Name Bar: View digital history of primary signal, from 0 to 10 means or medians (default). Implement Testing Protocols for evaluating and learning breathing. Evaluate breathing habits and teach/learn new mechanics consistent with good chemistry. Choose predefined breathing test protocols: breathing mechanics challenges. Configure Breathing Template controls: inhalation, exhalation, and transition times. Configure Template tracking features: multiple kinds of faces, balls, and colors. Create unique data records with task ID markers for each test. Review results during live sessions and in the Cloud Database. 9

Page 11

BREATHING-RATE CHALLENGE Learn to “allow” breathing rate and volume to self-regulate. Configure moving target on Template: types of faces or balls. Set number of breathing rates for testing (two to six different rates). Define each breathing rate to be implemented (4 - 25/minute). Assign the time for breathing at each of the assigned rates (1 - 5 minutes). TRANSITION-TIMES CHALLENGE Learn to “allow” for the respiratory reflex through negative practice. Define two kinds of breaths: a minimum and a maximum transition time. Set the minimum transition time between exhale and inhale (0 - 20 seconds). Set the maximum transition time between exhale and inhale (0 - 20 seconds). Assign a specific number of times that each kind of breath is to be completed. Set number of minimum - maximum transition sequence repetitions presented. Organize Tasks that trigger good and bad breathing habits. Configure Task Sequences for evaluating and learning breathing. Choose a task to begin a task sequence: Baseline, Challenge, Recovery, and User-defined. Choosing your first task will begin a new data record automatically if you have selected a Client. Click on Stop Task Sequence when you are finished to immediately review the testing results. Create and save User Defined Sequences if desired for future applications. Provide animated feedback for easier understanding. Less technical breathing feedback learning is helpful for children. SMILE: Change Facial Expressions by learning to regulate PetCO2. FILL the Barrel: Maintain the right level PCO2 concentration in the Barrel. TOUCH the Inner Circle: Complete the exhale, breathe gently. Audio and special effects feedback provide for more intuitive learning. Self-regulation breathing, not external manipulation, is a fundamental objective. AUDIO: Choose the source: speaker, headset, microphone. Provide audio feedback based on threshold settings, including: sound off/on, analog (continuous) & digital sounds (discrete), volume increase/decrease, musical notes, animal sounds, and even automated verbal feedback, i.e., mmHg call-outs for PetCO2. VISUAL: Provide visual feedback based on threshold settings, including signal color, background color, colored zones, animated displays. Manage live session user information for optimal record keeping. Record who is teaching and who is learning, and for what. Choose Clients, create new Clients, edit Client Profiles. Choose Groups, create new Groups, edit Group Profiles. Do Groupwork with up to six Clients and monitor them in the field. Create new Associate Trainers and edit their Profiles. Take Notes at any time, review them during the session, or in the Database. Take pictures of screens (PNG) or individual graphs at any time. Review pictures in slide format during the session or in the Database. Collect data for presentation in flexible and practical formats. Using data in “smart” ways make for better teaching and learning. Start and stop data collection. Start new data records within the same session Review multiple data records separately or together in the Database. Mark specific within-session data records with task and test labels. Pause/unpause data collection within the same record with time markers. Annotate live data by panning the ongoing recording. Data is marked as Homework when Clients conduct sessions without Trainers. Data is associated with the Associate Trainer assigned to a Client. Data is designated as “Self” data when doing personal work. Collect data directly on cell phones when in the field while wearing the vest. 10

Page 12

Customize Display features and Graph features within Displays. Teaching and learning require unique live physiology display configurations. Freeze the screen, pan the history, annotate the graph. Change signal features: color, lines, bars, thickness, actual data points. Set thresholds for audio and visual feedback. Reconfigure preset signal displays and save them as alternative displays. Change text font size for better screen readability and visibility. Control X-axis settings: Zoom in and out time frames (time window). Control Y-axis settings: Invert and/or move the display to left/right side. Change PetCO2 signal value expressions: mmHg, %-PCO2, kilopascals. Change live history data points: means, medians, or moving averages. View & Set signal averages and medians for digital readouts associated with graphs. Collapse/close whole screen, or only specific graphs. CLOUD ACCOUNT (DASHBOARD AND DATABASE) The CapnoTrainer® Management System CLOUD DATABASE provides for maximum data management flexibility for your Clients your Trainers, and yourself. Clients can view data reports, session images, Zoom video recordings, and fill-in PDF forms that they and their Trainers have completed and uploaded. You and your Associate Trainers (if any) can create and edit data reports of all kinds, including single session reports, homework reports, multi-session reports, and Groupwork reports. The Cloud Database is divided into two sections, the DASHBOARD and the DATABASE, each of which are described below. MANAGEMENT DASHBOARD Configure your System for Personal use only. Configure your System for working with Clients. Configure your System for use by Associate Trainers. Configure your System for doing Groupwork. Provide Clients and Trainers with personal logins. Unique Dashboards are provided for Clients and Trainers. Track the work of your Clients. Track the work of your Associate Trainers. Track the Clients of your Associate Trainers. Choose Preconfigured Data Report Templates. Create alternative versions of Template Reports. Create, Edit and View Single-Session Data Reports. Create, Edit and View Multiple-Session Data Reports. Choose Sessions and Signals for Multi-Session Reports. Create, Edit and View Groupwork Session Data Reports. Compare data amongst Groupwork participants. Create, Edit and View Homework Session Data Reports. Practice using the Database with Prerecorded Data. Manage Zoom recordings of Sessions. Download 12 different blank fill-in PDF forms. Upload 5 completed fill-in PDF forms for Clients. Upload 7 completed fill-in PDF forms for Trainers. View/download completed Client/Trainer forms. View Homework assignments submitted by Clients. Create and edit Client and Trainer Profiles. View and Download PDF copies of Data Reports. View Notes taken during selected live sessions. View Slide Show of snapshots taken for selected sessions.DATABASE Take Report Notes within each Data Report. Make PDF copies of Data Reports. Create multiple Reports for specific sessions. View Breathing Testing results in separate records. View Task sub-session data within separate records. View live session markers associated with tests and tasks. View multiple data records within single sessions. View data pauses and associated delay time. Review all session data or just a subset data record. View Zoom recordings of current session. View Session Notes taken during live session. View slide presentation of Images collected in Live Session. View PDF of previous session while in current session. Annotate Graphs within Data Reports. Replay data in a live format, pause and reset. Control X-axis time and Y-axis signal value ranges. Link changes on one graph with other graphs. Pan graphs, moving forward/back with mouse. Zoom IN/OUT specific regions of X-axis (time). Change graphical features: colors, lines, bars, grids. View annotations recorded during Live Sessions. Control/View numerical tables associated with graphs. Set data point sizes on graphs, link them with tables. View means, medians, and standard deviations. Export Data in variable formats. Auto-assemble comprehensive reports including forms, session notes, report notes, session snapshot images, and PDF of customized data reports created in the database. 11

Page 13

AADDMMIINN ((&& TTRRAAIINNEERR)) CCOOMMPPUUTTEERR DDAASSHHBBOOAARRDD The Dashboard side-bars shown below includes all options: Clients, Associate Trainers, and Groupwork. The Trainer Dashboard does not include Associate Trainers and subscription options. The Personal and Client Dashboards are described at the end of this section. Proceed without a Client name. Users may run a session entirely without recording data by clicking here. Users may ALSO enter an existing Client or a new Client at any time AFTER beginning a session, and then record data. Choose a Client and proceed. You must always return here (DASHBOARD) to start a new session with a new Client. Users may select an existing Client (including yourself) before beginning a session, and then decide to record data, or not. The default Client list is for ACTIVE Clients. Alternatively, users may choose INACTIVE Clients or ALL Clients. Enter New Client and proceed. Users may create a NEW Client before beginning a session, and then later decide to record data, or not. Run a Group Session (will only appear if the Group option has been selected in the user profile) If a customer owns multiple CapnoTrainers they can be run simultaneously for monitoring up to six clients at a time. Click here to choose a preexisting Group by its name to enter the program. The default Group listing is for ACTIVE Groups. Alternatively, Client may choose INACTIVE Groups or ALL Groups. Users may create a NEW Group by clicking on the GROUPS sidebar. Users may also start a Group session at any time AFTER beginning a session, and then record data. CLOUD DASHBOARD - Sidebar Access the Cloud Dashboard to create, Edit, and View all Database Reports and Records. Internet disconnection message: “You are not connected to the Internet. Please connect now or try again later.” Session data, notes, and images (snapshots) are autosaved to the CLOUD DATABASE. If the user becomes disconnected from the Internet, these data and files are stored in temporary files until reconnected and are then automatically uploaded. Note: Data, notes, and images are NOT available on the computer, except during live sessions. 12

Page 14

Manage Software Subscription Click here to manage the CapnoTrainer Management System™ annual subscription account: The user may choose to (1) update the software program on the computer manually or automatically as new versions are released, (2) renew the annual software subscription manually or automatically, and (3) make immediate payment for subscription renewal. The cost of the annual subscription is a three-tier arrangement: (a) one instrument, (b) 1 - 6 instruments (groupwork), and (c) 7 or more instruments. Customers will receive a notification 30 days before expiration of their subscription reminding them to either (1) take note that their credit card will be charged on the due date, OR (2) make payment before the due date, which can done by clicking on RENEWAL in the email they will also receive. GROUPS - Sidebar (will appear only if configured in the profile) Customers who own multiple CapnoTrainers can run them simultaneously and monitor up to six Clients at a time. These options allow users to create, edit or delete Group profiles on their COMPUTER DASHBOARDS. Additions and changes users make here will be automatically saved to their CLOUD DASHBOARDS. If disconnected from the Internet, these changes will be saved to a temporary file and automatically uploaded when reconnected. Data collection for Groups is managed in the same way as it is for individual Clients, that is, when entering the CLOUD DATABASE DASHBOARD creating, editing, and viewing data reports is the same. Add a new Group. Clicking here will bring up a Group profile form. Create a name for the Group, assign the group to ADMIN (owner) or to an alternate Trainer, assign a registered instrument to each client from the dropdown menu, and specify the hardware type (CapnoTrainer P6.0 USB, P6.0 Bluetooth, or 5.0). P6.0 and 5.0 instruments CANNOT be mixed. AND, use the SAME INSTRUMENT for the SAME CLIENT in successive groupwork sessions; the readings will vary somewhat from instrument to instrument. Add Clients by clicking on “Add Client; assign an instrument. Remove a Client by clicking on “Remove Client.” If a new instrument needs to be added, click on “Register another instrument.” Save the Group Profile by clicking on “Create Group Profile.” 13

Page 15

Edit a Group Profile. Click here to edit a Group profile any time, should there be a new participant, or someone who drops out or doesn’t show up. A Group can be deactivated or reactivated in the profile as shown below. ASSOCIATE TRAINERS – Sidebar (will appear only if configured in the profile) These options allow the user to create, edit or delete Associate Trainer profiles on the COMPUTER DASHBOARD. Any changes users make here will be automatically saved to the CLOUD DATABASE. If disconnected from the Internet, then these changes will be saved to a temporary file and automatically uploaded when reconnected to the Internet. Add a new Associate Trainer. Click here to add a new Trainer Profile. Enter the Trainer’s name and email address. Click on “Create Trainer Profile” and an automatic email will go out to the Trainer with instructions to complete the profile, download the software, and create a password for entering the Computer Dashboard and accessing the Cloud Dashboard. This allows Associate Trainers to manage their own Clients by creating, editing, and/or viewing data reports, session notes and images, forms, Zoom recordings, and their own profiles. Edit an Associate Trainer Profile. Click here to edit an Associate Trainer Profile, including changing the password and to deactivate/reactivate the Trainer. 14

Page 16

CLIENTS - Sidebar These options allow users to create, edit or delete Client profiles on their COMPUTER DASHBOARD. Any changes made here will be automatically saved to the CLOUD DASHBOARD. If disconnected from the Internet, these changes will be saved to a temporary file and automatically uploaded when reconnected. Add a new Client. Click here to add a new Client Profile. Enter the Client’s name and email address. Click on “Create Client Profile” and an automatic email will go out to the Client with instructions to complete the profile, download the software, and create a password for entering the Computer Dashboard and accessing the Cloud Dashboard. This allows Trainers to work with their Clients live on Zoom while in the field. It allows Clients to self-monitor, test themselves, learn new breathing habits, and complete homework assignments in the field. Clients can also view data reports, session records, and Zoom recordings as well as submit forms and homework assignments. Edit a Client Profile. Click here to edit a Client Profile, including changing the password and to deactivate/reactivate the Client. MY PROFILES - Sidebar 15

Page 17

Personal Profile. Click here to make new configuration selections and to update profile information. Hardware Profile. A listing of all instruments and serial numbers are listed here. Multiple 5.0 or earlier instruments must be registered here. REGISTRATION ISSUES: If you receive messages saying that you need to register the instrument when you have already done so, click on Unregister CapnoTrainer. Then reregister, the instrument in the usual fashion (5.0 or 6.0). SUBSCRIPTION MANAGEMENT - Sidebar Auto-update Choose auto or manual update. Auto-update is the default and is recommended. Auto-subscription Choose to renew your subscription automatically, manually, or RENEW now. LOGOUT - Sidebar PERSONAL DASHBOARD Begin New Session. Cloud Database. My Profiles. Subscription Management. Log out. CLIENT COMPUTER DASHBOARD Begin new session with Trainer. Begin new session without Trainer (for independent work and homework) Go to your Cloud Database Dashboard. View Data Reports, Records, and Forms Download Fill-in PDF Blank Forms Upload My Forms to Database Upload My Homework Assignments 16

Page 18

LLIIVVEE PPHHYYSSIIOOLLOOGGYY Live monitoring, recording options and control features are organized into FIVE different CONTROL BARS: #1: Main Menu Bar; #2: Screen Controls Bar; #3: Display Options Bar; #4: Signal Controls Bar; and #5: Display Controls Bar. There are also TWO sub-bars, the Name Bar and the Corollary Physiology Bar, that make up part of the Signal Controls Bar. MAIN MENU BAR (purple band, top of screen) Right side of MAIN MENU BAR: Information Clock Time, Session Time, Record Time, Name of Client, Name of Trainer, and Dashboard. If a user is recording for personal use, the username will appear twice. Click on Dashboard to return to Computer Dashboard. If a user is data recording and tries to exit, the user will be prompted to either save or discard the data. If a user has made display setting changes, they will remain when returning the Dashboard and starting a new session. Left side of MAIN MENU BAR: Action Options Physiology: View/Hide Live Screens. Turning off live screens can be essential to assisting clients in focusing on their own experience. Click here to turn ON/OFF all graphs in a DISPLAY OPTION. This option makes it easier for users to focus their Clients on breathing experience rather than technology during a learning session. Trainers often ask their Clients to cover or turn away from the screen. Hardware: Select hardware type here. Return to the DASHBOARD and then back here if changing hardware type for NEW session. The CapnoTrainer type connected, 5.0 or P6.0, will automatically be determined by the Management System if you have registered only one type of CapnoTrainer (5.0 or P6.0), BUT if you have registered both types you must make a hardware selection. Click on CapnoTrainer - Simulated should you wish to practice using the software without connecting an instrument. You can even collect artificial data if desired. Data: Click here to record corollary physiology and/or HRV physiology. Users may not always want to record this data. To record data, click on the DATA RECORD icon on the SCREEN CONTROLS BAR. Turn ON/OFF data recording for Corollary physiology signals. The default is OFF. Turn ON/OFF data recording for HRV signals (if this option has been purchased). The default is ON. Clients: Select an existing Client, or enter a new Client. You must always go back to the DASHBOARD to start a NEW session. Three choices are available: Add a client. Complete the Client Profile form presented. Active Clients Only. Uncheck it for ALL Clients. Choose a Client name. Images: View PNG files saved for the current session, that is, Images saved by clicking on the “take a picture” icons located on both the SCREEN CONTROLS BAR (whole screens) and DISPLAY CONTROLS BAR (specific graphs). Once data recording has begun, Images will be automatically saved with Client data and uploaded to the CLOUD DATABASE. If a Client has not been selected or data is not recording, images will save in a defaulted folder, Capno Records, on your desktop. Click on the SAVE IMAGES/NOTES icon to the far right of the SCREEN CONTROLS BAR to save them. Click on Images to access the “pictures” (Images) taken. Click right and left arrows to sequence through a slide presentation of the saved Images. Both full screen and individually saved graph Images will appear in the same slide sequence. Images can be accessed in the CLOUD DATABASE at any time by selecting the Client name and session date. When beginning a new session with a new Client, a new Images file is initiated; there is no longer access to previous Images. If the user is not connected to the Internet, Images are saved to a temporary file and auto-uploaded at a later time. Once a session has ended, the Images are available in the CLOUD DATABASE or in the CAPNO RECORDS folder on your desktop. 17

Page 19

Notes: Take, amend, delete, save a session notes Once data recording has begun, Notes will be automatically saved with Client data and uploaded to the CLOUD DATABASE. If a Client has not been selected or data is not being recorded, notes along with Images will save in a defaulted folder, Capno Records, on your desktop; click on the SAVE IMAGES/NOTES icon to the far right of the SCREEN CONTROLS BAR to save them. Notes can be accessed in the CLOUD DATABASE at any time by selecting the Client name and session date. When beginning a new session with a new Client, a new Notes file is initiated; there is no longer access to previous Notes. If the user is not connected to the Internet, Notes are saved to a temporary file and auto-uploaded at a later time. Once a session has ended, the Notes are available in the CLOUD DATABASE or in the CAPNO RECORDS Folder on your desktop. Click on Notes and enter/add text any number of times at any time during data recording. Add, edit and clear (erase) Notes at any time during the session. Groups: RUN a Group, ADD a group, or EDIT a Group. Choose an existing Group. Configure a new Group. Edit an existing Group: delete, replace, and reassign Clients. Choose an option and follow the self-explanatory instructions. Choose up to six instruments for up to six Clients. Note: This option will appear only if GROUP has been activated in the user’s ADMIN profile. Once a Group has been selected, either before running a session or within a session, the GROUP DISPLAY OPTION is automatically activated and all other DISPLAY OPTIONS will gray-out. If a Run a Group was already selected on the Computer Dashboard, it may be edited here, e.g., adding, deleting, or replacing a Client. Additional instruments may also be registered as previously described. Help: Click here to see the complete Operating Manual. Point the mouse at an icon or at a graph, hold the Ctrl key down and left click with the mouse for specific information. SCREEN CONTROLS BAR – LEFT SIDE: Indicator and Adjustment icons (below the MAIN MENU BAR) Icons include: (1) Internet connection ON/OFF (2) Bluetooth Strength, (3) Battery Life remaining, (4) Water Trap status, (5) Online or Offline, (6) Number of separate Data Records in the session (e.g., a breathing test), (7) Name of current Task or Test (if applicable, e.g., Baseline), and (8) Adjust PCO2 level (+/- 0-5 mmHg), e.g., -1 mmHg for room PCO2). When Battery Life drops to 5% and Water Trap status is bad, these icons will flash RED. See instructions for changing water trap (to right). Note: If PCO2 value suddenly drops radically, the Trap may be clogged. Change the Trap immediately. SCREEN CONTROLS BAR – RIGHT SIDE: Action Options SCREEN CONTROLS are general control features, although if a feature does not pertain to a Display option selected, it will not be present, e.g., History options. Each individual graphical presentation, however, can be adjusted by using its associated horizontal SIGNAL CONTROLS BAR and vertical DISPLAY CONTROLS BAR. SCREEN CONTROL icons are organized by their functionality. CONNECT CAPNOTRAINER®: Turn ON/OFF the hardware here. Although the CapnoTrainer version is selected automatically (USB P6.0, Bluetooth P6.0, or 5.0), there are occasions when clicking on HARDWARE on the MAIN MENU BAR may be required. START/SAVE A DATA RECORD: Click here to begin/end a DATA RECORD. Many sessions will consist of just one DATA RECORD, but a user may create multiple DATA RECORDS within a single session simply by ending data recording and starting again. If more than 30 minutes passes between two Data Records the second Data Record will be saved as a separate session. Pictures (Images) and Notes taken are also saved to the Session. 18

Page 20

If the user waits more than 30 minutes between DATA RECORDS within the same session, the second DATA RECORD will be shown as a New Session and not as a second DATA RECORD within the Same Session. In the event of an Internet service interruption, the data will be saved in a temporary file and uploaded automatically when reconnected. If there is a Bluetooth disconnection, a new DATA RECORD will begin when reconnected. PAUSE/UNPAUSE DATA RECORD: The user may PAUSE data recording within a single DATA RECORD, and then continue (UNPAUSE) it when desired, without ending the ongoing DATA RECORD and having to start a new one. The PAUSE and its length of time will be shown within the same Data Record. CHOOSE TASK (SUB-SESSIONS): Users may create learning protocols by organizing task sequences, such as Baseline (BL), Challenge (CH), Recovery (RC), and if desired user-defined tasks (by clicking Other). Click on a task to begin a Task DATA RECORD, e.g., Baseline. Run it for any period of time, then click on a second Task, e.g., Challenge, and run it until ready to either select a third Task or to stop the Sequence altogether. Clicking on Stop Task Sequence ends the DATA RECORD and presents the user with choices: Start a New Data Record, Continue Without further Data Recording, Review Results, and Close. Task category MARKERS will appear both on live screens and in the CLOUD DATABASE. Click on Stop Task Sequence to abort a sequence at any time. The user may also create automated sequences by clicking on Create User Sequence. 1. Specify a Task Sequence Name. 2. Enter a Name for each Task. 3. Create a 1-3 letter/number abbreviation for each task. 4. Specify the Time Period for each Task. 5. Create up to 10 more tasks (12 total). 6. Click on Create Task Sequence. 1. Select an automated custom task sequence. 2. Edit, save, or delete the task if desired. 3. Start Task Sequence. 4. The sequence will automatically stop after the last task. 5. Click on Stop Task Sequence to abort early if desired. 6. The same choices will appear at the end of the sequence. CHOOSE HISTORY GRAPHS: Some DISPLAY OPTIONS permit turning ON and OFF live HISTORY GRAPHS, where users can select how many HISTORY GRAPHS they wish to see in combination with a real-time signal. These DISPLAYS include PCO2 waveform, End-tidal CO2, Capnia Index (with 0, 3, or 6 HISTORY GRAPHS options), the Breathing Testing (with 0 or 3 HISTORY GRAPHS options), and HRV, RSA, HR (with 0 or 3 HISTORY GRAPHS). CHOOSE CONFIGURATION: Users may choose either the defaulted screen option, or an alternative configuration created and saved by the user. The user thus has the option of choosing two different versions of the DISPLAY OPTIONS. AVE ALT CONFIGURATION: After adjusting graphs and their features for DISPLAY OPTIONS, a user may SAVE these changes as alternative screen options which can be accessed at any time by clicking on the CHOOSE CONFIGURATION icon (above). When not saved, these changes are also retained when exiting to the Dashboard, but not when logging out of the software. FREEZE/UNFREEZE SCREEN: Users may freeze/unfreeze the screen for live data review purposes at any time. This action has no effect on data recording. Once the screen is frozen, the Pan Icon will appear at the bottom of the GRAPH CONTROL BAR for each graph for the selected DISPLAY OPTION and permit the user to scroll through signal histories. Upon unfreezing the screen, the Pan icon will disappear. See DISPLAY CONTROLS BAR later in the manual. CLEAR SCREEN: Users may clear the display of data on all screens at any time without any effects on data collection itself. A user may wish to do so for instructional purposes. TAKE A PICTURE: Users may take any number of PNG pictures of the full screen. These pictures are then available for review in a slide format at any time during data recording as well as in the Session Record saved in the CLOUD DATABASE. MUTE VOLUME: Turn off computer speakers. 19

Page 21

INCREASE FONT SIZE: Increase the size of the fonts for better readability. DECREASE FONT SIZE: Decrease the size of the fonts for less visual clutter. DOWNLOAD IMAGES AND NOTES: You may download a PDF copy of your images and notes without having to data record or go to the Cloud to view them. After taking pictures and notes, click on this icon and enter the name of your Client when prompted. You may access images/notes by client name and date in the CAPNO RECORDS folder on your desktop. OBSERVABLE AND RECORDABLE SIGNALS (18 signals) Breathing physiology (8 signals) Standard breathing physiology signals: PCO2 Waveform (raw data), End-tidal PCO2 (PetCO2), Breaths/min, Capnia Index1 Corollary breathing signals (airflow algorithms): Gasps/min, Aborted breaths/min, Breath-holds/min, Relative Volume/min2 1The Capnia Index indicates mmHg PetCO2 above or below a PetCO2 threshold of 35 mmHg. 2Relative Volume/min is shown on a scale of 1 to 10, where 10 represents the largest relative volume Cardiac physiology (10 signals) Real-time signals include Beat-to-Beat Heart Rate (raw data), Respiratory Sinus Arrythmia (RSA) Amplitude (HR change from inhale to exhale in beats/minute), RR Interval (tachograph, msec) and FFT. History graphs include Arousal (SDNN, ms), Parasympathetic Tone (RMSSD, ms), Parasympathetic Reserve (pNN50, %), HF (high frequency), LF (low frequency), and VLF (very low frequency). SEVEN of the breathing signals are “derived signals,” that is, seven algorithms based on the PCO2 wave form. Three of these algorithms can be adjusted by the user: PetCO2, breaths/min, and breath-holds/min. Adjusting these three algorithms is described below in the SIGNAL CONTROLS BAR section of this Manual. Algorithmic breathing signals: PETCO2 MMHG: Observable in live breath to breath, histogram, and numerical formats Peak readings, wherein (1) min peak is no less than 15 mmHg, (2) preceding inhale drops to 0 – 5 mmHg, and (3) difference between last two peaks is no greater than 3 - 5 mmHg (user adjustable, defaulted to 5). CAPNIA INDEX MMHG: Observable in live breath to breath, histogram, and numerical formats The Index indicates mmHg PetCO2 above or below a PetCO2 threshold of 35 mmHg. BREATHS/MIN: Observable live histogram and numerical formats Time between PetCO2 peak readings where (1) each peak is no less than 10 to 15 mmHg (user adjustable, defaulted to 15), and (2) the preceding peak is separated by an inhale which drops to 0 – 5 mmHg. BR-HOLDS/MIN: Observable in live numerical format only as a corollary physiology signal Time between inhale and exhale, user adjustable, 0.5 by tenths up to 5 seconds (defaulted to 1.0 second), where (1) an inhale is defined as drop in PCO2 to below 5 mmHg, and (2) an exhale is defined as an increase in PCO2 of at least 5 mmHg. GASPS/MIN: Observable in live numerical format only as a corollary physiology signal A GASP occurs when (1) an exhale begins at level of 5 mmHg PCO2 or higher, (2) the exhale leads to a rise of at least 2 mmHg but no more than 8 mmHg, and (3) subsequently an inhale is initiated leading to a drop of at least 2 mmHg. ABORTED-EXHALES/MIN: Observable in live numerical format only as a corollary physiology signal A single or a series of aborted breaths are defined as (1) PetCO2 value #1 – PetCO2 value #2 = 4 mmHg or more, (2) subsequent values of PetCO2 of 1 – 5 breaths do not rise more than 1 mmHg, and (3) a rise of PetCO2 of at least 4 mmHg following one or a series of up to five PetCO2 values. RELATIVE-VOLUME/MIN: Observable in live numerical format only as a corollary physiology signal Values are calculated based on the relationship between one-minute averages of breathing rate and PetCO2. Relative volumes are shown on a scale of 1 to 10, as shown below, where 10 represents the largest volume. 1-min average PetCO2 ÷ 1-min average br/min, where: 45 mmHg = 15 ÷ bpm; 40 mmHg = 20 ÷ bpm; 35 mmHg = 25 ÷ bpm 30 mmHg = 30 ÷ bpm (reference point) 25 mmHg = 35 ÷ bpm; 20 mmHg = 40 ÷ bpm; 15 mmHg = 45 ÷ bpm mmHg (inverse) 5 br/min 10 br/min 15 br/min 20 br/min 25 br/min 45 = 30 -15 = 15 3.00 (15/5) 1.50 (15/10) 1.00 (15/15) 0.75 (15/20) 0.60 (15/25) 40 = 30 -10 = 20 4.00 (20/5) 2.00 (20/10) 1.33 (20/15) 1.00 (20/20) 0.80 (20/25) 35 = 30 -5 = 25 5.00 (25/5) 2.50 (25/10) 1.67 (25/15) 1.25 (25/20) 1.00 (25/25) 30 = 30 - 0 = 30 6.00 (30/5) 3.00 (30/10) 2.00 (30/15) 1.50 (30/20) 1.20 (30/25) 25 = 30 + 5 = 35 7.00 (35/5) 3.50 (35/10) 2.33 (35/15) 1.75 (35/20) 1.40 (35/25 20 = 30 + 10 = 40 8.00 (40/5) 4.00 (40/10) 2.67 (40/15) 2.00 (40/20) 1.60 (40/25) 15 = 30 + 15 = 45 9.00 (45/5) 4.50 (45/10) 3.00 (45/15) 2.25 (45/20) 1.80 (45/25) 20

Page 22

DISPLAY OPTIONS BAR (up to eleven options) Immediately below the SCREEN CONTROLS BAR is the DISPLAY OPTIONS BAR, a horizonal listing of up to nine options that may be adjusted in numerous ways and then saved as Alternative Screens by going to the SCREEN CONTROLS BAR and clicking on the Save Alt Configuration icon. Users may choose either the defaulted configuration OR the alternate configuration by clicking on the Choose configuration icon on the SIGNAL CONTROLS BAR. Learn about how to implement the numerous signal and graphical features of the DISPLAY OPTIONS by reviewing the SIGNAL CONTROLS BAR and DISPLAY CONTROLS BAR descriptions presented later in this Manual. 1. PCO2 Waveform The live PCO2 raw waveform signal is graphically presented, defaulted to a one-minute full width screen (adjustable by user). Three 30-minute (adjustable by user) history graphs are presented below it, including PetCO2, Breaths/min, and the Capnia Index (mmHg below/above 35). Read about adjusting X-axis time periods later in this Manual (GRAPH SETTINGS icon on SIGNAL CONTROLS BAR). Users may toggle additional history graph options by clicking on the Screen Control icon (HISTORY GRAPHS, top right), including no history graphs for a full screen presentation of the PCO2 waveform or six history graphs for yet more physiology. The additional three history graphs include Aborted Exhales, Breath-holds, and Gasps/min. The NAME BAR is defaulted to presentation of the last three 30-second medians (or averages) of PetCO2. The COROLLARY PHYSIOLOGY BAR is defaulted to one-minute medians (or averages) for six corollary signals: Aborted Exhales/min, Breaths/min, Breath-holds/min, Capnia Index, Gasps/min, and Relative Volume. See a full description how to change these default settings later in this Manual. Or, go to the NAME BAR and COROLLARY PHYSIOLOGY BAR icons on the SIGNAL CONTROLS BAR. 2. End-tidal CO2 (PetCO2) Live “breath to breath” changes in End-tidal PCO2 ( PetCO2) are graphically presented, defaulted to a one-minute full width screen (user adjustable). Note that the PetCO2 values will NOT change until the next breath takes place. Users may elect to implement the “moving average” function to get a better picture of how PetCO2 is changing on the average from breath to breath, that is: each “next PCO2 reading” can be set to be an average of the last 1, 2, 3, or 5 PCO2 readings. Read about using this feature and to adjust X-axis time periods later in this Manual. Or, go to the GRAPH SETTINGS and SIGNAL SETTINGS icons on the SIGNAL CONTROLS BAR. The user may toggle additional history graph options by clicking on the Screen Control icon (HISTORY GRAPHS, top right), including no history graphs for a full screen presentation of the PCO2 waveform or six history graphs for yet more physiology. The additional three history graphs include Aborted Exhales, Breath-holds, and Gasps/min. The NAME BAR is defaulted to presentation of the last three 30-second medians (or averages) of PetCO2. The COROLLARY PHYSIOLOGY BAR is defaulted to one-minute medians (or averages) for six corollary signals: Aborted Exhales/min, Breaths/min, Breath-holds/min, Capnia Index, Gasps/min, and Relative Volume. See a full description of how to change these default settings later in the Manual. Or, go to the NAME BAR and COROLLARY PHYSIOLOGY BAR icons on the SIGNAL CONTROLS BAR. 3. Capnia Index Live “breath to breath” changes in Capnia Index are graphically presented, defaulted to a one-minute full width screen (adjustable by user). Note that the Index values will NOT change until the next breath takes place. Users may elect to implement the “moving average” function to get a better picture of how the Index is changing on the average from breath to breath, that is: each “Index reading” may be an average of the last 1, 2, 3, or 5 Index readings. Read about how to use this feature and to adjust X-axis time periods later in this Manual. Or, go to the GRAPH SETTINGS and SIGNAL SETTINGS icons on the SIGNAL CONTROLS BAR. The user may toggle additional history graph options by clicking on the Screen Control icon (HISTORY GRAPHS, top right), including no history graphs for a full screen presentation of the PCO2 waveform or six history graphs for yet more physiology. The additional three history graphs include Aborted Exhales, Breath-holds, and Gasps/min. The NAME BAR is defaulted to presentation of the last three Capnia Index medians of PetCO2. The COROLLARY PHYSIOLOGY BAR is defaulted to one-minute medians for seven corollary signals: Aborted Exhales/min, Breaths/min, Breath-holds/min, Capnia Index, End-tidal CO2 (PetCO2), Gasps/min, and Relative Volume. See a full description of how to change these defaults later in this Manual. Or, go to the NAME BAR and COROLLARY PHYSIOLOGY BAR icons on the SIGNAL CONTROLS BAR. 4. Feedback Screens Feedback screens include 1-minute (adjustable by user) graphical presentation of three live signals, including Raw PCO2, breath to breath PCO2 values, and the Capnia Index. The NAME BAR is defaulted to the last three 1-minute medians (adjustable by user) for signals on all three graphs (up to ten may be selected by going to the NAME BAR icon on the SIGNAL CONTROLS BAR). The Corollary Physiology Bar has been activated only for the Raw PCO2 graph and includes six signals: Aborted Exhales/min, Breaths/min, Breath-21

Page 23

holds/min, Capnia Index, Gasps/min, and Relative Volume (up to seven may be selected by going to the COROLLARY PHYSIOLOGY BAR on the SIGNAL CONTROLS BAR). Making NAME BAR, COROLLARY PHYSIOLOGY BAR, and X-axis time period changes are described later in this Manual. Or, go directly to the GRAPH SETTINGS, NAME BAR, and COROLLARY PHYSIOLOGY icons on the SIGNAL CONTROLS BAR. 5. Breathing Mechanics Breathing mechanics include five algorithmic signals, each presented in 30-minute history graphs as 30-second medians (both adjustable by the user): breaths/min, gasps/min, aborted exhales/min, breath-holds/min, and Relative Volume Index. Two of these algorithmic signals, Breaths/min and Breath-hold/min, may be adjusted by the user. The NAME BAR is defaulted to the last three 1-minute medians (adjustable by user) for signals on all three graphs (up to ten may be selected by going to the NAME BAR icon on the SIGNAL CONTROLS BAR). See a full description of how to change X-axis time periods and number of NAME BAR medians/means later in this Manual. Or, go to the GRAPH SETTINGS and NAME BAR icons on the SIGNAL CONTROLS BAR. 6. Breathing Testing The upper portion of the Testing display (shown below) is a BREATHING TEMPLATE that provides for breathing training/learning along with three different breathing test options (challenges) described below. Clients track either a BALL or a FACE by inhaling while it rises and exhaling while it descends. The lower portion of the display (not shown below) includes a graph of the Raw PCO2 waveform with the option of adding or removing three history graphs by clicking on the History Graphs icon on the SCREEN CONTROLS BAR. Simply click on “Start Template Animation” to initiate the TEMPLATE display. SIGNAL CONTROLS BAR: Template Settings, Faces/Markers Challenge Settings, Exhale-Inhale Transition Challenge Settings, Breathing Rates Challenge Settings, Stop Challenge, Collapse Template. BREATHING TEMPLATE SETTINGS Time scale (X-axis), breathing rate, % time inhaling vs. exhaling, and type of Balls and Faces are all adjustable. X-axis Range: Set the time frame of the template wave display as follows: 10, 20, 30 seconds and 1, 2, 3, & 5 minutes. Increasing the time range increases the number of template waves visible at any one time. Breaths per minute: Set the number of breaths per minute. The speed of the ball moving up and down the sine waves determines the breathing rate, not including the transition time between exhale to inhale. Adjustable Breathing Rate settings are used for automating the Breathing Rate Challenge Test settings. Time for One Breath (TOB – in sec): The time for a single breath, based on the breathing rate selected above, will appear here as a reference only. If, for example, a breathing rate is set at six, the TOB (time for one breath) is 10 seconds. Exhale Time (% of TOB, default 60%): The ball/face will move from peak to trough of the template wave at a speed corresponding to the percentage of the total time set for each breath. If, for example, the TOB is 10 seconds, and the percent exhalation is set at 60, the ball/face will travel from peak to trough in six seconds (0.6 X 10 seconds). 22

Page 24

Inhale Time (% of TOB, default 40%): The ball/face will move from the end of the exhalation-inhalation transition period to the peak of the template wave at a speed corresponding to the percentage of the total time set for each breath. If, for example, the TOB is 10 seconds, and the percent inhalation is set at 40, the ball/face will travel from trough to peak in four seconds (0.40 X 10 = 4). Transition Time (default 0.5 sec): The time between exhalation and inhalation is the transition time and is adjustable by the user: 0.00 (no time), 0.25, 0.50, 0.75, 1, 1.5, 2.0, 3.0, 5.0, 7.0, 10, 12, 15, 20, 30 seconds. Adjustable Transition Time settings are required for automating the Exhalation-Inhalation Transition Challenge Test settings. Marker Type: Types include Balls (red, blue, black, purple, green) and Faces (angry, dizzy, laughing, sad, sunglasses, tired, grin, flushed). These markers are used in the Face/Marker Breathing Test. CHALLENGE 1: FACES & MARKERS The FACE challenge is a learning task (e.g., five minutes) involving setting a breathing rate (slow, fast, or otherwise) with facial expression feedback for learning to maintain optimal respiratory chemistry, i.e., alveolar PCO2, at a specific breathing rate; chemistry in most cases should be optimal regardless of rate which changes immediately and continuously throughout the day. Clients track faces moving up and down the template waves where expressions change based on levels of PetCO2, transitioning from angry to laughing (e.g., dialog box settings below). The user may also track the Raw PCO2 waveform on the graph below the template. Users may set the time duration for the Challenge (1, 2, 3, 4, 5, 10, 15 minutes) and set facial expressions for the differing levels of the PetCO2 concentrations. The defaults are shown below. Facial expressions (mmHg): angry, 20 or less; dizzy, 21 - 25; tired, 26 - 30; sad, 31 - 35; smiling, 36 - 40, laughing, 41 - 45. Clicking on START CHALLENGE will begin the Challenge, whether or not data recording has been previously engaged. If data is not being recorded, the outcome of the challenge can be reviewed immediately following the test, simply by clicking on REVIEW RESULTS in the dialog box that pops up at the end of the Challenge (as shown below). If the user has already been data recording, the previous data record will auto-close and a new unique Challenge Data Record will auto-begin when clicking on “Start Challenge.” If, however, the user has not been previously recording data, the user may do so simply by closing the dialog box shown, selecting (or creating) a Client from the Client dropdown list on the MAIN MENU BAR, and then returning to this dialog box. Clicking on “Start Challenge” will automatically begin data recording. When the Challenge time period ends (e.g., five minutes), the Challenge Data Record also ends and is integrated into the Session Data Record, accessible in the Cloud Database. If a Challenge Data Record has been created, a user has three action options: Start a New Data Record, Continue Without Further Data Recording, or Review Results. If data has NOT been recorded, the user can click on Review Results, as shown in the smaller dialog box below. Clicking on “Review Results” will take the user directly to the Raw PCO2 waveform record where the screen will be frozen for panning and reviewing the Challenge data record; unfreezing the screen will return the user to the live screen. CHALLENGE 2: EXHALATION-INHALATION TRANSITION TIME The Exhalation-Inhalation Transition Time Challenge is a learning task where Clients can learn to disengage aborted exhalation behavior (habit) through reducing anxiety between breaths, allowing for the exhale rather than forcing it, allowing for the inhale rather than “taking the breath,” finding and allowing for the inspiratory reflex for learning to trust the respiratory system, and experiencing the transition time as a momentary place of peace and rest. 23

Page 25

The normal transition time between breaths is short, approximately a half second, after which inhalation reflexively occurs. The Transition Time Challenge consists of sequencing two different transition times, one as the minimum time and one as the maximum time between breaths. For example, the minimum transition time might be set at zero, so as to engage a Client in aborted exhalation, a learned breathing behavior (habit) that may be compromising a Client’s performance. The maximum transition time might be set at one second so as to help a Client identify and experience the inspiratory reflex. Practicing the two behaviors alternately, that is, aborting the exhale and allowing for transition time, provides for “negative practice” training where Clients can learn to disengage the older breathing habit and replace it with the new one. Choices need to be made for setting up the Transition Time Challenge as follows: (1) Choose a marker, ball or face, for operating the template. (2) Choose the minimum transition time between breaths, e.g., zero. (3) Choose the number of breaths for which the minimum transition time will be engaged, e.g., three breaths. (4) Choose the maximum transition time between breaths, e.g., one second. (5) Choose the number of breaths for which the maximum transition time will be engaged, e.g., three breaths. (6) Choose the breathing rate, defined in this case as the time from the start of an inhalation to the end of an exhalation; it does not include transition time between breaths. And, (7) choose the number of repetitions of minimum and maximum transition cycles, e.g., two repetitions in this example, would mean 3 aborted breaths, 3 allowed breaths, 3 aborted breaths, 3 allowed breaths. Selectable transition times: 0.0, 0.25, 0.50, 0.75, 1.0, 1.5, 2.0, 3.0, 5.0, 7.0, 10, 12, 15, 20, and 30 seconds. Number of breaths during Min and Max transition times: a number entered by user. Selectable breaths per minute: 6, 8, 10, 12, 15, 18. Selectable repetitions: 1- 5. Transition times are abbreviated in the data record as “TT” followed by the transition time, e.g., TT-0.5. Click on “Start Challenge” to engage the automatic sequencing of transition times and data recording. Following the last repetition, the Challenge Test ends and the data auto-saves (if recorded) to the Cloud Database as a unique data record within the overall session record. The results are also available for immediate review. Go to the previous page for details. CHALLENGE 3: BREATHING RATE CHALLENGE The Breathing Rate Challenge is used for (1) testing for the alignment of breathing mechanics (rate) with chemistry (PetCO2) and (2) learning to align mechanics with chemistry based on intuitive experience; PetCO2 should remain in the normal range (35 -45 mmHg) within a wide range of rates (4 - 24). Clients are challenged with a series of differing breathing rates (e.g., 12, 6, 18, 24), each for a specific time frame (e.g., two minutes each) as shown in the dialog box below. Choose number of different Testing Rates: 1, 2, 3, 4, 5, or 6. Set a Time Period for Rates: 1, 2, 3, 4, or 5 minutes. (Same time period for all rates) Choose a Marker Type: Ball color or Facial Expression Set a Breathing Rate for each Testing Rate: 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 28 Breathing Rate Challenges are abbreviated in the data record as “BR” followed by the breathing rate, e.g., BR-12. Click on “Start Challenge” to engage the automatic sequencing of the breathing rates and data recording. Following the last rate in the series, the data auto-saves as a unique data record within the overall session record. Options appear for immediate review of the challenge, starting a new data record, or continuing without data recording. STOP CHALLENGE: Data autosaves and options appear for data review, starting a new record, or continuing without recording. COLLAPSE TEMPLATE: Close the Template display to observe the Raw PCO2 graph only. EXPAND: Reopen the Template display (if collapsed) 24

Page 26

7. HRV, RSA & HR This Display Option offers two kinds of displays, user selectable with a SWITCH-SCREEN ICON on the SIGNAL CONTROLS BAR: (1) Beat-to-Beat calculated Heart Rate (HR), OR (2) Respiratory Sinus Arrythmia (RSA) breath to breath amplitude (High Frequency HRV). The HR signal and the RSA are defaulted to a 60 second X-axis (user adjustable). Click on this icon to switch between the two signals. Both displays include the raw PCO2 signal graph. Click on SIGNAL SETTINGS icon for Beat-to-Beat HR and RSA signal setting options. See GRAPH SETTINGS for other options. On the Beat-to-Beat HR graph, users may (1) Hide the Signal, (2) Show Peak (to trough) Markers, (3) display Signal Type (Sample Points Line, or both), (4) change the Line Width, (5) change Sample Point Size, and (6) change the Color of Points and Lines. On the RSA Amplitude graph, users may (1) implement the “moving average” function to “smooth” the signal for a better picture of how amplitude is changing on from breath to breath, that is, a user selectable medians of the last 1, 2, 3, or 5 RSA values; (2) hide the signal; (3) choose the Signal Type (Outlined or Filled Bars); and (4) Adjust signal Color. The NAME BAR is defaulted to presentation of the last three 30-second medians of Heart rate. The COROLLARY PHYSIOLOGY BAR is defaulted to one-minute medians (or averages) for six corollary signals: Aborted Exhales/min, Breaths/min, Breath-holds/min, Capnia Index, Gasps/min, and Relative Volume. See a full description how to change these default settings later in this Manual. History graphs for either HR or RSA live signal presentations may be selected by clicking on the “choose history graphs” icon on the SCREEN CONTROLS BAR. The history graphs include three 30-minute graphs (user adjustable) each presented with 60-second medians (user adjustable) located in the bottom third of the display: Heart Rate, RSA Amplitude, and PetCO2. The NAME BAR associated with each is defaulted to presentation of the last three 30-second medians of each (user adjustable). 8. HRV – Time Analysis The features of this display option are the same as (7) above except that the primary display is the RR Tachograph (where each point displays the time between last two beats in msec) instead of calculating heart rate. The SWITCH-SCREEN ICON for observing RSA instead of RR may also be used. History graphs for either HR or RSA live signal presentations may be selected by clicking on the “choose history graphs” icon on the SCREEN CONTROLS BAR. The history graphs include three 30-minute graphs (user adjustable) each presented with 60-second medians (user adjustable) located in the bottom third of the display: Arousal, Parasympathetic Tone, and Parasympathetic Reserve. The NAME BAR associated with each is defaulted to presentation of the last three 30-second medians of each (user adjustable). 9. HRV – FFT The FFT spectrum display presents all HRV frequencies in real time: VLF, LF, and HF are displayed in different colors. The bottom graph depicts Raw PCO2 for referencing FFT changes associated with breathing. Adjustments to the FFT may be made by clicking on the one icon located on the far right of FFT graph display. Users may (1) observe the FFT in line or bar plots, (2) display the Y-axis as Power or Amplitude, (3) show part or all of the spectrum, (4) show gridlines or not, (5) locate the Y-axis position to the left or right side, (6) display the signal in outlined or filled formats, (7) adjust the minimum and maximum Y-axis values, and (8) adjust colors for VLF, LF, and HF frequency bands. History graphs may be selected by clicking on the “choose history graphs” icon on the SCREEN CONTROLS BAR. The history graphs include three 30-minute graphs (user adjustable) each presented with 60-second medians (user adjustable) located in the bottom third of the display: Very Low Frequency (VLF), Low Frequency (LF), and High Frequency (HF). The NAME BAR associated with each is defaulted to presentation of the last three 30-second medians of each band width (adjustable). 25

Page 27

10. Animated Feedback There are two Animation Display Options: (1) A “BARREL OF CO2“ shows input and output valves where ideally “CO2 in” and “CO2 out” are equivalent, while holding PetCO2 steady at or above 35 mmHg. With each breath, the PetCO2 changes and is reflected in the level of purple “fluid” (CO2) in the barrel. (2) An EXPANDING CIRCLE that surrounds the barrel moves out while inhaling and in while exhaling, tracking the flow of air. An inner circle representing the PCO2 threshold (defaulted to 35 mmHg) can be set by clicking on the Audio Feedback icon. Breathing above threshold (default) keeps the background color white, while breathing below threshold fogs the background with color. Audio Feedback options may be engaged for simultaneous sound and visual feedback. Along with breath-to-breath PetCO2 feedback there is also continuous air flow feedback in the form of a circle expanding from and to the side of the barrel or face, thus providing further feedback. Inhalation moves the circle outward away from the barrel or face, while exhalation relaxes the circle allowing the breather to touch a fixed inner circle (35 mmHg) that triggers a color change; an aborted exhale, for example, will fail to touch the inner circle (less than 35 mmHg) and thus fail to trigger a color change. 11. Groups Most users will choose a Group on the Computer Dashboard before entering the software. Upon entering the software, the GROUP display option is auto-selected and all other DISPLAY OPTIONS are grayed out. Note, that clicking on the GROUPS Option will not function if a Group selection has not yet been made. Group sessions may also, however, be initiated within the software itself. In this case, click on GROUP on the MAIN MENU and select an existing Group. A Group may then be edited, e.g., replacing or deleting a participant, by clicking on “Edit a group.” And, a new Group may be created by clicking on “Add a group.” The GROUPS display will show from two to six Raw PCO2 graphs, depending upon the Group configuration programmed by the user. The SIGNAL CONTROLS BAR provides four signal controls options: GRAPH SETTINGS, SIGNAL SETTINGS, THRESHOLD SETTINGS, and LINK SETTINGS. Clicking on LINK SETTINGS will gray-out all SIGNAL CONTROLS BAR icons on all graphs, except the first one where signal control adjustments can be made for all graphs simultaneously. Data collection for Groups is managed in the same way as it is for individual Clients, that is, when entering the CLOUD DATABASE DASHBOARD, the user will have options to create, edit, and view data records. SIGNAL CONTROLS BAR (horizontal bar, above the graph to the right) Every DISPLAY option (e.g., PCO2 Waveform) consists of a fixed or variable number of GRAPHS (e.g., 1 to 7 for PCO2 Waveform), each of which includes its own SIGNAL CONTROLS BAR horizontally located in its upper righthand corner. The SIGNAL CONTROLS BAR consists of three to nine different icons which provide access to signal control features. Here are differences: 1. History screens do not provide the COROLLARY PHYSIOLOGY BAR option. 2. Three history graphs provide for modifying ALGORITHM SETTINGS: breaths/min, PetCO2, and breath-holds/min. 3. When graphs have been collapsed (hidden), an EXPAND icon (+ sign) will appear on the SIGNAL CONTROLS BAR for all graphs. 4. The RSA display option provides a SWITCHING icon for choosing between beat-to-beat HR and RSA amplitude graphs. 5. The Breathing Template display has unique icons for setting breathing rates, creating patterns, and choosing challenges. 6. The Animated Feedback display option also has unique icons specifically relevant to its functionality. 7. The Groups display option includes a LINKING icon for simultaneous control of all Graphs. 8. Feedback control icons are NOT available for some Display Options: Breathing Mechanics, Breathing Testing, and Groups. The unique SIGNAL CONTROLS BAR features for the Breathing Template, Animated Feedback, and Groups DISPLAY OPTIONS are described earlier in this Manual. The SIGNAL CONTROLS BAR includes four signal control icons for history graphs, seven signal control icons for most live signal graphs, and eight signal control icons for HRV graphs. However, if a graph has been hidden by clicking on the GRAPH CONTROLS BAR Collapse icon, an Expand icon (+, plus sign) will also appear on the SIGNAL CONTROLS BAR for reinstating the graph (as shown below). The NINE possible icons include: Graph Settings, Signal Settings, Threshold Settings, Name Bar Settings, Corollary Physiology Bar settings, Switch-screen, Audio feedback, Visual feedback, and Expand (if hidden). SIGNAL CONTROLS BAR features are described below. Graph Settings icon (first icon on the left) Users have many Graph settings options to choose from, some of them generic and others unique to the display option selected. Live signal and history display options include some or all of the options shown below: 26

Page 28

X-AXIS RANGE: On live signal screens, users may adjust the X-axis to show 10, 20, 30, 60, 120, 180, and 300 seconds of live data. On live history screens users can adjust X-axis to show 5, 10, 15, 20, 30, 45, and 60 minutes of live data. UNITS: Graphs containing PCO2 and PetCO2 signal values (the Y-axis) may be observed as mmHg (default), percentage PCO2, or kilopascals, e.g., 38 mmHg = 5% PCO2 = 5.07 KPa. SHOW ANNOTATIONS: If signal record has been annotated, by using the Annotations icon on the GRAPH CONTROLS BAR, these annotations may be made either hidden or visible. SHOW GRID LINES: Y-axis gridlines can be turned ON (default) or OFF as graphical reference points. Turning OFF the gridlines simplifies the display while using it for feedback training with Clients. INVERT Y-AXIS: The Y-axis values for PCO2 and PetCO2 signals may be inverted as an alternative way of providing live feedback for clients. Clients and Trainers often prefer to see breathing signals rise while breathing in and descending while breathing out. MIN/MAX Y-AXIS: The signal value range is defaulted to full scale, but may be adjusted for other purposes by entering unique minimum and maximum Y-axis values, e.g., while doing color zone-feedback training. See Visual Feedback description. AUTO-OFFSET (HRV ONLY): Choose a Y-axis range and turn ON Signal-Offset to auto-track Heart Rate, thus keeping it visible at all times within a user selected range, e.g., 20, for easy pattern viewing. Y-AXIS POSITION: Users sometimes prefer to locate the Y-axis on the left or right of a GRAPH, where its position may make a difference in the training/learning protocol being implemented by a Trainer or a Client. Signal Settings (second from the left) Signal Settings vary from one DISPLAY OPTION to the next. Three of them are shown below. MOVING AVERAGES: Breath to breath PetCO2, Capnia Index, and RSA Amplitude signal values may appear erratic and hard to track. Calculating an average of the last three or more signal values after each breath “smooths” the appearance of the signal and provides a visually better sense of its trend for feedback training/learning. This feature permits the user to create a MOVING AVERAGE of 1, 3, 4, or 5 signal values; the default is one (feature OFF). The MOVING AVERAGE function is restricted to these three signals only. EDIT ALGORITHM: Three of the history screens permit the user to partially adjust (edit) the algorithmic equations, as follows: Breath-hold/minute: Users may adjust the definition of a breath-hold in half second intervals, from 0.5 to 5.0 seconds (default 2.0 sec). PetCO2: Users may exclude aborted exhales from PetCO2 averages by adjusting acceptable changes of PCO2 from one breath to the next, that is, they may choose 3, 4, or 5 mmHg as an acceptable change from breath 1 to breath 2. If it exceeds this, then the previous breath is defined as having been aborted (default 4 mmHg). Breaths/minute: Users may adjust the definition of a “breath” by adjusting what they consider to be an exhale, that is, if PetCO2 does not rise to at least 8 to 20 mmHg during the exhale, adjustable by the user, the “exhale” is not considered to be the end of a breath (default 15 mmHg). HIDE SIGNAL: Users may hide the signal while training or learning, that is, make it temporarily invisible. SHOW PEAK MARKER: Users may mark the peak signal values for easy identification. SIGNAL TYPE: Depending upon the DISPLAY OPTION selected (see above), users may choose from a variety of visual appearances, including Sample Points, Line, and Line & Sample Points for live signals; or Outlined or Filled bars for history graphs. 27

Page 29

TYPE OF LINE: Users may determine the appearance of line graphs: solid, dotted, dashed, long-dashed, dash-dot, and long-dash-dot. LINE WIDTH: Users may use the slide bar to adjust the thickness of the line. SAMPLE POINT SIZE: Users may adjust the Sampling Point size by using the slider bar. COLOR: Users may use the slider bar to adjust the color of the signals. Threshold Settings Threshold signal values can be adjusted for all signals in all DISPLAY OPTIONS as shown below. VALUE: Users set the threshold based on learning/training criteria desired. Most of the displays are defaulted to 35 mmHg, that is, the minimally desired concentration of PCO2. NOTE: All audio & visual feedback settings linked to threshold in the feedback dialog boxes are regulated by the values entered here. HIDE THRESHOLD: Users may hide/display the threshold line. LINE WIDTH: Users may elect to make threshold lines subtle or distinct, as desired, by using the slider provided. TYPE OF LINE: The threshold line may visually appear as: solid, dotted, dashed, long-dashed, dash-dot, and long-dash-dot. COLOR: Users may use the slider bar to adjust the color of the signals. Name BAR Settings Each graph contains one signal. The name of this signal appears at the top of the graph to the far left. Immediately following the signal name are digital readouts of its last three 30-second medians. Clicking on the NAME BAR SETTINGS icon brings up a dialog box that permits users to turn the BAR ON/OFF, select the number of averages/medians to display (1, 2, 3, 5 or 10), assign either the mean or median statistic, adjust the signal history time (20, 30, 60, 90, 120, and 300 seconds), and. The default is three medians and ten is possible only for full length graphs. IMPORTANT: Setting means/median values on the NAME BAR also sets the average/median values displayed on the history graphs. Switch-screen (HRV, RSA & HR Display Option only) Clicking on the Switch-screen icon toggles between “Beat-to-Beat” calculations of Heart Rate and “Breath to Breath” calculations of Respiratory Sinus Arrhythmia (RSA) amplitude. Heart Rate, RSA Amplitude, and PetCO2 history graphs are present in both cases. Corollary BAR Settings The COROLLARY PHYSIOLOGY BAR consists of up to seven algorithmic signal medians: aborted-exhales/min, breaths/min, breath-holds/min, Capnia Index, End-tidal CO2 (PetCO2), gasps/min, and relative volume. Clicking on the COROLLARY BAR setting icon brings up a dialog box that permits the user to turn the BAR ON/OFF, determine which signals to include on the BAR, and assign signal medians/averages times to each signal: 30 seconds; 1, 2, and 5 minutes (1 min default). Auditory Feedback Settings Users may Activate or Deactivate audio feedback for breath-to-breath PetCO2, Capnia Index, breath-to-breath RSA, and the animation display option, but not Groupwork applications. Choose the Sound Source, e.g., headphone or speaker outputs. Audio includes Digital (e.g., bell), Animal (e.g., bird), and Verbal (PetCO2 mmHg readouts) feedback. Choosing a Sound Type provides for associated options, e.g., bell. Set the Volume as desired. 28

Page 30

Sounds can be set to be available only above threshold, only below threshold, or always; enter the threshold value where indicated. Thresholds may also be set by clicking the THRESHOLD SETTINGS icon on the SIGNAL CONTROLS BAR. Visual Feedback Settings Users may Activate or Deactivate visual feedback for learning to regulate Raw PCO2, PetCO2 and RSA amplitude. Feedback includes Background Color and Signal Color that can be threshold managed wherein visual changes occur only above threshold, only below threshold, or always. Set the signal threshold value where indicated. Color Zones may be shown as reference areas on graphs where Clients can learn to breathe into more optimal PetCO2 zones as indicated below: DARKER GREEN-eucapnia (40-45 mmHg) LIGHTER GREEN-eucapnia (35-40 mmHg) , YELLOW-moderate to mild hypocapnia (30-35 mmHg), ORANGE-serious to moderate hypocapnia (25-30 mmHg), and RED-severe hypocapnia to serious hypocapnia (20-25 mmHg). When zones are selected the Y-axis automatically shifts to 20 – 45 mmHg from 0 – 50 mmHg. The zone feature is useful for PCO2 feedback training/learning. Expand Screen (appears only when graph is collapsed) Users may collapse/hide and reinstate the presence of a GRAPH by clicking the Collapse icon on the GRAPH CONTROLS BAR and then reinstating its presence by clicking on the Expand + (plus) icon which appears at the right end of the SIGNAL CONTROLS BAR, but only when the GRAPH has been collapsed. DISPLAY CONTROLS BAR (vertical bar, to the side of a graph) Every DISPLAY OPTION (e.g., PCO2 Waveform) consists of a fixed or variable number of GRAPHS (e.g., 1 to 7 for PCO2 Waveform), each of which includes its own DISPLAY CONTROLS BAR vertically located immediately to the right of its associated GRAPH. The BAR consists of seven icons which provide access to control features as follows: Collapse screen Users may collapse (hide) and reinstate the presence of a GRAPH by clicking the Collapse icon on the GRAPH CONTROL BAR and then reinstating its presence by clicking on Expand + (plus) icon which appears at the far-right end of the SIGNAL CONTROLS BAR only when the GRAPH has been collapsed. Full Screen Users may choose to display a GRAPH full screen while hiding all other DISPLAY OPTION graphs. The Full Screen icon is a toggle switch so that clicking on it a second time will restore the original GRAPHS. Annotate, show data points DUAL FUNCTION ICON: (1) Viewing digital values: While observing a live signal, clicking on this icon allows the user to position the mouse over the live signal and read out its digital value at any given point in time; clicking on it again toggles it to the OFF position. (2) Inserting annotations: After freezing the DISPLAY SCREEN and panning the live history (see below), the user may click on this icon and then move the mouse to any position on the graph, left click, and enter a short notation, e.g., anxiety. See below. Users may mark and ANNOTATE as many times as they wish by clicking new positions. Clicking on the same icon again turns OFF the annotation function. Notations are saved with the data and are accessible when reviewing data in the CLOUD DATABASE. Zoom in Zooming-in provides a higher resolution look at the real-time signal, that is, the range of the X-axis is reduced. It provides for a better look at the nuances in airflow for detecting changes in breathing mechanics, e.g., breath-holding. Zoom out Zooming-out provides a bigger picture of what’s been happening over a more extended time frame, that is, the range of the X-axis is larger. It provides for a better live overview of breathing patterns. 29

Page 31

Take Picture Users may take PNG pictures (Images) of a specific graph for taking a closer look at data of interest. These pictures are integrated with all pictures taken during the session (or data record) and can be easily accessed as a slide show and reviewed by Trainer and Client at any time during the session by clicking the Images Option on the MAIN MENU BAR. All of these images are also saved as part of the Session Record and are available to ADMIN, the Trainer and the Client in the CLOUD DATABASE. Pan Live History (only visible if the FREEZE icon has been activated) Click on the Freeze/unfreeze icon on the SCREEN CONTROLS BAR and Panning icon will appear at the bottom of the DISPLAY CONTROLS BAR. Left-click and hold anywhere on the graph and drag right or left to review live history data. The X-axis range may be adjusted by clicking on the Graph Settings icon on the SIGNAL CONTROLS BAR (e.g., five minutes of viewable data instead of one minute), thus making it easier to pan through larger amounts of live data. Click on the same Freeze icon to unfreeze the screen, that is, to return to the live screen. Freezing and panning have no effect on data recording. 30

Page 32

INITIAL STEPS If you are working with Associate Trainers, STEP 1 will ask you to choose a Trainer. ADMIN is the defaulted Trainer so that you can immediately manage your own Clients. You may select specific Trainers to see their associated Clients and you may choose ALL Trainers to see ALL Clients in your System. The default setting is for viewing Active Associate Trainers, but you make click the INACTIVE BOX to see a listing of all Trainers, active and inactive. If you are working with Clients, but have no Associate Trainers, STEP 1 will ask you to choose a Client. Only Clients for whom data have been recorded will appear in the dropdown window. The default setting is for viewing Active Clients, but you may also click the INACTIVE BOX to see listing of ALL Clients, active and inactive. If you have collected data for Groups and wish to create a GROUPS DATA REPORT, check off the GROUPS BOX located between the ACTIVE and INACTIVE BOXES. Your Group Names will appear. Uncheck the GROUPS BOX to return to the Client listing. After selecting a CLIENT or a GROUP (Step 1 or 2) choose a specific SESSION (Step 2 or 3). All sessions are marked by date and time. There are two kinds of sessions: Professional and Personal. Professional means a learning session a Trainer did with a Client. Personal means a Homework session where data was collected by a Client working alone. Personal sessions are marked HW for homework. You can create data reports for both kinds of sessions, Professional and Personal. Choosing a Client (or Group) and a session will activate all available options. Active options will change from gray to black. If you are creating multisession data reports, do not choose a session. Simply choosing a client will activate the CREATE & SAVE A MULTISESSION REPORT option. Choosing a session will deactivate the MULTISESSION REPORT option. CREATE DATA REPORTS After taking the Initial Steps described above, selecting these options will lead you directly into the CLOUD DATABASE where you can create and save DATA REPORTS, including REPORT NOTES. 31

Page 33

Create & Save a Session Data Report Click here to see a listing of PRECONFIGURED DATA REPORTS. Click on a PRECONFIGURED DATA REPORT to enter the CLOUD DATABASE for the client/session you selected above. Then, configure the Report, make PDF copies, take Report Notes as desired, and then save the Report. You may create multiple reports for same session simply by selecting another PRECONFIGURED DATA REPORT option. You may create Client Homework (HW) Sessions Reports in the same way you create reports for your own Client sessions. Create & Save a Multisession Report Click here to build a MULTISESSION DATA REPORT for the client selected. Only graphs are available (no tables). A menu will appear with the following options: (1) Choose one to three of the following six signals: Raw PCO2, PetCO2, Capnia Index, breaths/min, beat-to-beat HR, RSA Amplitude. (2) Choose the sessions you wish to combine into a single report. After making your selection, click on CREATE REPORT to enter the database. Then configure the Report, make PDF copies, and take Report Notes as desired. Create and Save a Group Session Report (will not appear if your profile is not configured for GROUPS) Check the GROUP BOX at the top of the screen. Select a Group and a corresponding session date. You may select from among ACTIVE and INACTIVE GROUPS if desired. A listing of four PRECONFIGURED GROUP REPORTS will appear. Choose a Report. Then configure the Report, make PDF copies, and take Report Notes as desired. 32

Page 34

PRACTICE: Creating Data Reports (demo data only) The PRACTICE option provides users with an opportunity play with demo data and report making features. The menu presents three kinds of demos: single session, multisession, and group session data. VIEW & EDIT DATA REPORTS After taking the Initial Steps described above, selecting any of these options will lead you directly into the CLOUD DATABASE where you can View and Edit an existing DATA REPORT. These options include viewing and editing single SESSION, MULTISESSION, GROUP SESSION, and HOMEWORK SESSION REPORTS as follows: (1) If you choose a Client without specifying a Session, only the MULTISESSION DATA REPORT option will become available. (2) If you select a Client AND a Session then either or both the SESSION DATA REPORT and the CLIENT HOMEWORK DATA REPORT options will appear, whichever is available. (3) If you select GROUPS rather than CLIENTS, all other DATA REPORTS will gray-out. In all cases the original DATA REPORTS, along with any associated REPORT NOTES, will automatically appear and allow you to review, edit (revise), and resave them as needed. VIEW PDF REPORTS After taking the Initial Steps described above, selecting these options will permit you to View and Download PDF copies of all DATA REPORTS, and separately their associated REPORT NOTES taken while creating the original reports. These reports include Single SESSION REPORTS, MULTISESSION REPORTS, GROUP REPORTS, HOMEWORK REPORTS, and SESSION REPORT NOTES. Your Initial Steps selections will determine what options are active, or not (grayed-out). VIEW LIVE SESSION INFORMATION After taking the Initial Steps described above, you may View, Download, or print Notes and Images (pictures) created and saved during live sessions. Simply click on VIEW OR DOWNLOAD LIVE SESSION NOTES or LIVE SESSION IMAGES. You may also link a Zoom recording to the Client/Group session entered during taking the Initial STEPS above, or view a Zoom Recording previously linked to a Client or Group session. You may also delete these links. 33

Page 35

VIEW/MANAGE FORMS Download Fill-in PDF Blank Forms: Download or view any of 12 different fill-in PDF blank forms. There are 14 different fill-in PDF forms available to users, five of which are for Clients and nine for Trainers. Client forms: (C-1) Homework Record, (C-2) Interview Checklist, (C-3) Interview Questionnaire, (C-4) My Breathing Habits, and (C-5) Service Evaluation. Trainer forms: (T-1) Assessment Record, (T-2) Behavior Report, (T-3) Guided Breathing Record, (T-4) Learning Plan, (T-5) Learning Session Record, (T-6) Outcome Report, (T-7) Physiology Report, (T-8) Referral Report, and (T-9) Screening Report. Write to education@bp.edu about courses for helping you learn about using these forms. Upload Completed Client Forms: ADMIN and Trainers may upload the following forms on behalf of their Clients or Groups: C-2, C-3, and C-4 only. Clients may upload all five Client Forms, including C-1 (Homework Record) and C-5 (service Evaluation). Upload Completed Trainer Forms: Upload a Trainer Form by assigning it to a specific Client and is some cases to a specific session. Choose a form and it will upload to the Client or Client/session based on the form selected: Client name only: T-4, T-6, T-8, and T-9. Client name + session: T-1, T-2, T-3, T-5, and T-7. The Trainer Forms are then available for viewing by ADMIN, and the Trainer AND their Clients. 34

Page 36

View Completed Client Forms: The following dialog box will appear: Client Forms: C-2, C-3, C-4, and C-5. Homework uploads are viewed elsewhere. Choose a Trainer and/or choose a Client. View Completed Trainer Forms: The following dialog box will appear: Client name only: Forms T-4, T-6, T-8, and T-9. Client name + session: Forms T-1, T-2, T-3, T-5, T-7. Choose a Form, Trainer and/or a Client and a Session if required. View Completed Homework Assignment Forms: The following dialog box will appear. Choose Trainer, Client, and session. View or download Homework. VIEW, CREATE, EDIT PROFILES You may create, edit, delete, deactivate/reactivate, and save profiles for Clients, Associate Trainers, Groups, Hardware, and yourself. New Client, Edit Client: Activate new Clients, where emails are sent to them to complete their profiles for access to the Cloud. New Trainer, Edit Trainer: Activate new Trainers, where emails are sent to them to complete their profiles for access to the Cloud. New Group, Edit Group: Set up, configure, and edit Groups; register registered instruments not yet registered. Edit My Profile: Change personal data (including password), and activate other options (groups, associate Trainers. HRV). View/Edit Hardware Profile: Clicking here will present you with a list of registered instruments and their serial numbers. CapnoTrainers P6.0 are registered automatically; when you first plug one in for operation on the live screen, a dialog box will appear asking you for the serial number. When you plug in the first older version CapnoTrainer (5.0 or before) you will be also be prompted to enter the serial number, but all subsequent older ones must be registered by hand or you will not be able to do groupwork. Go to page 17 to see details regarding Hardware Profiles. 35

Page 37

SESSION REPORT ASSEMBLY You may conveniently assemble unique reports by choosing the various previously completed and saved records in the Database, e.g., forms, data, images, and notes, for specific Client sessions. ONLY the records you have previously completed will appear as possible selections for report assembly. See below for instructions and an example. Clicking on CREATE/SAVE REPORT will bring you to a screen with all of the report components (records) you have selected on the above screen. You may then, if desired, enter a Report Summary and Descriptive Captions for Session Image and PDF Data Records. You may access specific reports at any time by clicking on “View/Edit/Delete/Download Session Report.” See below. RECORDINGS BY DISTRIBUTORS On occasion your distributor will have a recording available with important information. If so, the side bar will flash to advise you. SUBSCRIPTION MANAGEMENT LOG OUT 36

Page 38

CCAAPPNNOO DDAATTAABBAASSEE CREATE & SAVE A SESSION DATA REPORT. Select a PRECONFIGURED DATA REPORT from the nine that appear on the listing. Preconfigurations The following are descriptions of nine PRECONFIGURATION options. You may reconfigure all of these PRECONFIGURATIONS in numerous ways as described in this Manual. REPORT OPTION 1: RAW PCO2, WITH PETCO2 AND BREATHS/MIN HISTORIES Row 1-2 of 4, Column 1 of 1: PCO2 Waveform; raw data (all samples); purple color; thin line; X-axis, full session; Y-axis, 0-50 mmHg Row 3-4 of 4, Column 1 of 2: PetCO2 history; 30 sec averages; medium gray color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 3-4 of 4, Column 2 of 2: Breaths/min history; 30 sec averages; blue color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 2: PETCO2 BREATH TO BREATH, WITH PETCO2 AND BREATHS/MIN HISTORIES Row 1-2 of 4, Column 1 of 1: PCO2 breath to breath; purple color; outlined bars; X-axis, full session; Y-axis, 0-50 mmHg Row 3-4 of 4, Column 1 of 2: PetCO2 history; 30 sec averages; medium gray color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 3-4 of 4, Column 2 of 2: Breaths/min history; 30 sec averages; blue color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 3: CAPNIA INDEX BREATH TO BREATH, WITH PETCO2 & BREATHS/MIN HISTORIES Row 1-2 of 4, Column 1 of 1: Capnia Index breath to breath; red/green; outlined bars; X-axis, full session; Y-axis, -20/+10 mmHg (35 =0) Row 3-4 of 4, Column 1 of 2: PetCO2 history; 30 sec averages; medium gray color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 3-4 of 4, Column 2 of 2: Breaths/min history; 30 sec averages; blue color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 4: BREATHING MECHANICS: GASPING, ABORTED BREATHS, BREATHHOLDING, RELATIVE VOLUME, AND BREATHS/MIN HISTORIES Row 1 of 2, Column 1 of 2: Gasps/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 1 of 2, Column 2 of 2: Aborted exhales/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis, auto-adjust Row 2 of 2, Column 1 of 3: Breath-holds/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 2 of 2, Column 2 of 3: Relative Volume/per min, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 2 of 2, Column 3 of 3: Breaths/min history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 5: BREATHING CHEMISTRY: PETCO2 AND CAPNIA INDEX HISTORIES Row 1 of 2, Column 1 of 1: PetCO2 history; 30 sec averages; medium gray color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 2 of 2, Column 1 of 1: Capnia Index; 30 sec averages; red/green; outline bars; X-axis, full session; Y-axis, -20/+10 mmHg (35 =0) REPORT OPTION 6: ALL BREATHING SIGNAL HISTORIES (7) Row 1 of 3, Column 1 of 2: PetCO2 history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 1 of 3, Column 2 of 2: Capnia Index; 30 sec averages; red/green; outlined bars; X-axis, full session; Y-axis, -20/+10 mmHg (35 =0) Row 2 of 3, Column 1 of 2: Gasps/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 2 of 3, Column 2 of 2: Aborted exhales/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 1 of 3: Breath-holds/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 2 of 3: Relative Volume/per min, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 3 of 3: Breaths/min history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust 37

Page 39

REPORT OPTION 7: BEAT TO BEAT HEART RATE AND RAW PCO2, WITH HEART RATE, RSA, & BREATHS/MIN HISTORIES Row 1 of 3, Column 1 of 1: Beat to beat heart rate; red color; thin line; X-axis, first 2 minutes; Y-axis, auto-adjusted window (see above) Row 2 of 3, Column 1 of 1: PCO2 Waveform; raw data (all samples); purple color; thin line; X-axis, 2 minutes; Y-axis, 0-50 mmHg Row 3 of 3, Column 1 of 3: Heart rate history; 30 sec averages; red color; outlined bars; X-axis, full session; Y-axis: auto-adjusted window Row 3 of 3, Column 2 of 3: RSA history; 30 sec averages; red color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 3 of 3: Breaths/min history; 30 sec averages; blue color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 8: RSA BEAT TO BEAT AMPLITUDES, WITH PETCO2, HEART RATE, RSA, & BREATHS/MIN HISTORIES Row 1 of 3, Column 1 of 1: Beat to Beat RSA; red color; outlined bars; X-axis, full session; Y-axis, auto-adjusted window (see above) Row 2 of 3, Column 1 of 2: Heart rate history; 30 sec averages; red color; outline bars; X-axis, full session; Y-axis: auto-adjusted window Row 2 of 3, Column 2 of 2: RSA history; 30 sec averages; red color; outline bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 1 of 2: Breaths/min history; 30 sec averages; blue color; outline bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 2 of 2: PetCO2 history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg REPORT OPTION 9: ALL HISTORIES Row 1 of 3, Column 1 of 3: PetCO2 history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: 0-50 mmHg Row 1 of 3, Column 2 of 3: Capnia Index; 30 sec averages; red/green; outlined bars; X-axis, full session; Y-axis, -20/+10 mmHg (35 =0) Row 1 of 3, Column 3 of 3: Heart rate history; 30 sec averages; red color; outline bars; X-axis, full session; Y-axis: auto-adjusted window Row 2 of 3, Column 1 of 3: RSA history; 30 sec averages; red color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 2 of 3, Column 2 of 3: Gasps/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 2 of 3, Column 3 of 3: Aborted exhales/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 1 of 3: Breath-holds/min history, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 2 of 3: Breaths/min history; 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust Row 3 of 3, Column 3 of 3: Relative Volume/per min, 30 sec averages; purple color; outlined bars; X-axis, full session; Y-axis: auto-adjust REPORT OPTION 910: TACHOGRAPH OF RR-INTERVAL WITH TIME AND FREQUENCY DOMAIN HRV COMPONENTS Row 1 of 3, Column 1 of 3: Tachograph of RR interval Row 2 of 3, Column 1 of 3: Arousal history, 30 second means Row 2 of 3, Column 2 of 3: Parasympathetic Tone history, 30 second means Row 2 of 3, Column 3 of 3: Parasympathetic Reserve history, 30 second means Row 3 of 3, Column 1 of 3: VLF Bandwidth history, 30 second means Row 3 of 3, Column 2 of 3: LF Bandwidth history, 30 second means Row 3 of 3, Column 3 of 3: HF bandwidth history, 30 second means The control features and options for creating and reviewing Data Reports are organized into three CONTROL BARS: Main Menu Bar, Graph Control Bar, and Signal Control Bar (available by left clicking anywhere on a graph). Main Menu Bar (purple band, top of screen, from left to right) ACTION OPTIONS Export Data: Create an ASCII, CSV, or EXCEL file for export to an external database or statistics program. Take Notes: Take Report Notes. Click CLEAR to erase notes. Click CONTINUE to leave the dialog box. Click Notes again to add more text. Make PDF: Enter NAME of PDF Report. You may then access this report on the Dashboard. Save Alt Configuration: Create an alternative version of a Preconfigured Data Report. Access it to the right of the Preconfiguration options. Save Report: Save the Report you’ve created along with your Report Notes. You may EDIT or VIEW saved Report & Notes on the Dashboard. VIEWING OPTIONS View/Hide Session Notes: Click here to view the Notes taken during the live session. View Session Images: Click here to review a “slide show” of the images collected during the live session. View Session Zoom Recording: Click here to review the Zoom recording for this live session. View PDF of Last Session: Click here to review a PDF copy of the last data session report. View/Hide All Tables: Click here to view all tables associated with graphs, or not. CLIENT, TRAINER, SESSION INFO: CLIENT name, TRAINER Name, SESSION Date/Time are presented on the MAIN MENU BAR. RETURN TO DASHBOARD: If you have made any changes in a PRECONFIGURATION, clicking on DASHBOARD will remind you to save the Report, or to exit without saving. 38

Page 40

CREATING MULTIPLE REPORTS IN THE SAME SESSION: Select another PRECONFIGURATION in the dropdown menu. You will be reminded to save and name the current Report first, OR to continue to the next PRECONFIGURATION without saving. ALTERNATIVE PRECONFIGURATION: You may choose either a defaulted preconfiguration, OR its ALTERNATIVE CONFIGURATION previously saved by you. Click on the dropdown menu located to the immediate right of PRECONFIGURATIONS options dropdown. MULTIPLE DATA RECORDS: If more than one DATA RECORD within the same session have been recorded, they may be accessed by clicking on last dropdown menu to the far right of the MAIN MENU BAR, e.g., breathing tests (all records or one). Graph Features GRAPH LABELING: At the top of a graph the signal name will appear on the left, and the X-axis Range & Data Point size on the right. Y-AXIS ICON: At the top of the Y-axis, there is a “Y” icon which will permit you to set the Y-axis (signal value) range, as desired. You may also choose measurement units including % PCO2, mmHg, and kPa. X-AXIS ICON: At the end of the X-axis, there is an icon which will permit you to set the X-axis (time) range as desired, as desired. ZOOMING IN/OUT: Move the mouse to a specific position on a graph, click, the then use the Mouse Scroll Wheel to zoon in/out. SIGNAL VALUES: Moving the mouse to a specific position on a graph, will post the signal value to the immediate right of the signal label. REPORT ANNOTATIONS: Point the mouse to a specific graph location, hold the “Ctrl key” down, and left click to enter a note. Click on the Annotation itself to edit or delete it. TASK-SESSIONS: If you have recorded task data, e.g., Baseline, Challenge, Recovery, you will see these divisions marked in the data. SESSION ANNOTATIONS: If you annotated your data during the live session, these notes will appear with the data. DATA PAUSES: If you paused data recording during a session, demarcations for these pauses will appear indicating when and how long. Signal Controls Bar: Right click within a graph to see the dialog box containing feature options. Set the X-axis and Y-axis ranges as desired. Click on MAX for displaying the full session. You may also double click the graph for full session display. Choose the data point size for history graphs (30 seconds and higher). Select number of moving averages,” if desired, to smooth data. Choose to see Mean or Median statistics history bar presentations. Set Signal Color, Signal Thickness, and Signal Type (dotted, line, solid bar, outlined bar). Click on the Show Gridlines to turn on and off vertical, horizontal, or ALL gridlines. Click on the check mark to set in place each selection. Graph Controls Bar (vertical) All graphs include the following feature icons: Use these icons to zoom IN or OUT of the X-axis (time frame). You can see or less data as desired. Move the data point of interest to the center position or the graph and then expand or contract the range as desired. Move the time window on the X-axis forward and back in time as desired. For example, set the X-axis to one minute, 00:00 to 01:00 (by going to the SIGNAL BAR or clicking the “X→” icon) and then click the right-pointing arrow to move the same one-minute range to 01:00 -02:00. You may replay the live signal by clicking on this “go-forward” icon, pause the signal by clicking on the “pause” icon, and reset the signal to the starting point of the recording by clicking on the “reset” icon. Click here to activate TABLES for the specific History Graph selected, NOT INCLUDING the PCO2 Waveform (Raw PCO2) . Turning on TABLES provides you with mean, median, and standard deviation statistics for the GRAPH you have selected and may have adjusted according to your own preferences. You may turn ON/OFF specific statistics simply by clicking on the label, e.g., median. You may also turn on TABLES for ALL GRAPHS by clicking on the VIEW/HIDE ALL TABLES Viewing icon. Choose the unit of measurement desired for PCO2, PetCO2, and Capnia Index. This includes mmHg, kPa (Kilopascals), and percent PCO2. 39

Page 41

Turn ON and OFF Live (session) and/or Report Annotations. And, display them as black flags or text labels. Annotations can be shown as black flags, or as text labels containing the text entered at the time of the recording. Click on the flag, or on the label, to switch to one or the other, as shown to the right. CREATE & SAVE A MULTI-SESSION DATA REPORT. Choose a Client. Click the MULTISESSION BOX located above the Session dropdown. The MULTISESSION REPORT Option will appear in bold; all other options will gray-out. If you click a session date, the MULTISESSION REPORT Option will disappear. Click on the Multisession Report Option and choose: (1) up to three of six possible signals, including Raw PCO2, PetCO2, Capnia Index, Breaths per Minute, Beat-to- Beat Heart Rate, and RSA amplitude; and (2) the SESSIONS you wish to assemble in the Report. Click CREATE REPORT. Once in the Cloud Database, up to six graphs will appear preconfigured on each page; no tables are available. Main Menu Bar ACTION ICONS FOR MULTI-SESSION REPORTS are the same as for Single Session reports, with one exception, Configure Linking: Export Data Take Report Notes Make PDF copy of Report Save Multi-Session Report CONFIGURE GRAPH LINKING (see paragraph below) The X-axis for all graphs is defaulted to full session recording time. You may adjust features on a (1) graph-by-graph basis (as in the case of single session reports), (2) signal-by-signal basis, and (3) multi-signal basis (two or three signals). On a signal-by-signal basis, adjusting one graph for one type of signal automatically makes the same adjustments for all other session graphs containing the same signal; e.g., if you make an X-axis change for the Raw PCO2 signal in session 1, the same X-axis change will automatically take place for all Raw PCO2 signal session graphs (e.g., sessions 2 -5). On a multi-signal basis, adjusting one graph for one signal automatically makes corresponding changes for all signals on all graphs. See dialog boxes below for making these selections. VIEWING ICONS FOR MULTISESSION REPORTS are mostly the same as for Single Session Reports, but differ as described below. View Live Session Notes View Live Session Images Watch Zoom Recording HELP (Manual) The options for Viewing LIVE SESSION NOTES and LIVE SESSION IMAGES permit you to choose the specific session of interest as shown in the dialog box below. Graph Controls Bar (vertical): These features are described above. Signal Controls Bar: These features are described above. (Right click anywhere on graph.) 40

Page 42

CREATE & SAVE A GROUP REPORT If you have collected data for GROUPS and wish to create a GROUPS DATA REPORT, check off the GROUPS BOX located between the ACTIVE and INACTIVE BOXES located above the Client dropdown. Your Group Names will appear; if you wish to see your Client listing again, uncheck the GROUPS BOX. Choose a session (date and time) and all available Cloud Dashboard options will change from gray to black; unavailable options will be grayed-out. Click on CREATE & SAVE A MULTISESSION REPORT and choose amongst four Preconfigured Group Reports. Two reports display 2 - 6 rows and two columns of graphs and two reports display 2 - 6 full length rows of graphs, both reports of which include up to six Clients. Only Raw PCO2 and PetCO2 signal data are available for Groups. All Preconfigured options auto-configure, e.g., the X-axis (time) based on the number of Clients in a group. Main Menu Bar Action icons and Viewing icons are the same as they are for single client report-making preconfigured report options with the exception of the Linking (action) icon which permits you to adjust features for all graphs simultaneously or independently. Simultaneous adjustment (default) means that a feature adjustment on one graph, e.g., X-axis (time) changes it on all graphs. Graph Controls Bar (vertical): These features are described above. Signal Controls Bar: These features are described above. (Right click anywhere on graph.) BETTER PHYSIOLOGY LTD 109 East 17 Street, Cheyenne, WY 82001 USA Email: tech@betterphysiology.com Tel: 307.773.0888 41

Page 43

Better Physıology,Ltd.Better Physıology,Ltd.Corporate office: 109 East 17th Street, Cheyenne, WY 82001 USA Tel: 1.307.773.0888Corporate office: 109 East 17th Street, Cheyenne, WY 82001 USA Tel: 1.307.773.0888Santa Fe offıce: 7 Camıno de Reu Cırcle Santa FE , NM 87506 USA Tel: 1.505.670.2874Santa Fe offıce: 7 Camıno de Reu Cırcle Santa FE , NM 87506 USA Tel: 1.505.670.2874tech@betterphysıology.com tech@betterphysıology.com www.betterphysıology.comwww.betterphysıology.com