NHC Cyclo-Therapy. Staying Healthy at Home : simplebooklet.com

NHC Cyclo Therapy Staying Healthy at Home CONTENTS Introduction to NHC Cyclo Therapy and History 3 7 NHC Cyclo Therapy Product Range 8 9 Why is NHC Cyclo Therapy different the benefits 10 13 NHC Cyclo Therapy Reducing Pain arthritis back muscle nerve 14 25 Staying Healthy at Home dealing with circulatory problems 26 30 NHC Cyclo Therapy Reducing Oedema 31 32 NHC Cyclo Therapy Effects on circulation 33 37 NHC Cyclo Therapy Effects on healing wounds 38 43 NHC Cyclo Therapy Muscle relaxation and stimulation 44 50 NHC Cyclo Therapy Restless Legs Syndrome 51 54 NHC Cyclo Therapy Chest clearance and relaxation 55 57 NHC Cyclo Therapy combined with the benefits of adjustable posture the ideal combination 58 62 DISCLAIMER WE SHOULD EMPHASISE THAT NHC Cyclo Therapy cycloidal vibration IS NOT A CURE FOR THESE CONDITIONS BUT IT CAN DO MUCH TO HELP ALLEVIATE THE SYMPTOMS ASSOCIATED WITH THEM IT IS DESIGNED TO COMPLEMENT THE RANGE OF CURRENT THERAPIES AVAILABLE FROM THE CUSTOMER S FAMILY DOCTOR AND ITS USE CAN ALWAYS BE DISCUSSED WITH A HEALTH CARE PROFESSIONAL IF YOU ARE CONCERNED THE CUSTOMER SHOULD NOT DISCONTINUE ANY CURRENT THERAPY WITHOUT FIRST SEEKING ADVICE 2 Staying Healthy at Home Introduction to NHC Cyclo Therapy Welcome to the NHC Cyclo Therapy guide this will help explain the principles applications and benefits of NHC Cyclo Therapy Medically certified NHC Cyclo Therapy is only available in our range of products and is supported by research undertaken in hospitals and universities in the UK and world wide This guide refers to a small selection of the medical evidence we hold that has been published or presented in medical journals or conferences It will explain some of the benefits of using our NHC Cyclo Therapy products and provide information on how and when to use the products to their full potential The benefits obtained may well vary from one individual to another and we hope you get the full benefits of using our products It is recommended that you try our products by having a qualified advisor demonstrate the various options available This will help with the techniques of using each one of our products before deciding which option is best and most suited to you OUR CONTRIBUTION Staying Healthy at Home We are passionate about helping those in need especially those most vulnerable children Our Crown Pin Foundation was developed with the sole aim of donating therapy products and raising money to benefit the lives of children and young adults throughout the UK Managed by a committed group of employees the foundation raises funds throughout the year through various activities involving our employees 100 of the money raised goes to several children s charities or in product donations to worthy causes We have donated over 20 000 to children s charities NHC Cyclo Therapy Designed Developed Researched and Manufactured in the UK 3

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What is NHC Cyclo Therapy NHC Cyclo Therapy is a unique three dimensional vibration generated by a sinusoidal electromechanical oscillator It is incorporated into various unique products manufactured in the UK by our company These may be easily used at home by an individual or by a medical or physical therapy professional in the home or clinic setting Staying Healthy at Home Where Can I find NHC Cyclo Therapy to stay healthy at home NHC Cyclo Therapy is featured within products from our group of companies including Adjustamatic Beds Niagara Therapy Vibrant Medical NHC Technology and Niagara Equissage This illustration shows the three dimensional circular movement created by cycloidal vibration This illustration shows the three dimensional circular wave transverse movement A transverse wave is a moving wave that consists of oscillations occurring perpendicular or at right angles to the direction of energy transfer IMPORTANT TO NOTE to make medical claims a product has to be audited and meet specific European medical device quality standards This assessment ensures quality safety and proof of effectiveness All NHC Cyclo Therapy products are registered as medical devices As such they are CE and UKCA marked and are audited to standards regulated by the UK medicines and healthcare regulatory authority Our Therapy products Meet Medical Device Standards We believe we are the only company in the UK manufacturing consumer therapy furniture to medical device standards All our therapy products are quality checked and adhere to the highest UK standards We are registered with the UK Government s Medicines and Healthcare Regulatory Authority MHRA and have ISO 9001 2015 and ISO 13485 2016 accreditation 4 Therapy Beds Chairs Therapy Beds Chairs NHC Portable Physiotherapy CSTP Pad Therapy Hand Unit Healthcare Products Equine Health 5

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Why is NHC Cyclo Therapy Different Initially there is no obvious difference between the feel of conventional vibration and the cycloidal vibration in our NHC Cyclo Therapy products However conventional vibration can produce an aggressive slapping or pounding at a high amplitude in a single direction of motion and at a high frequency Cycloidal vibration s acceleration rate is very low compared to other vibration techniques which can be up to 50 x higher This often produces an uncomfortable sensation that may be damaging to muscle and soft tissue An NHC Cyclo Therapy unit has a very special suspension system which is the reason it generates a three dimensional motion like a cyclone cycloidal vibration in a circular rising and falling motion This causes the energy to penetrate both gently and deeply into the body Staying Healthy at Home to straining or stressing a muscle which will then produce additional metabolic waste in an area This can cause soreness and swelling with too much load on the lymphatic system With NHC Cyclo Therapy s small amplitude and low acceleration very high muscle motor response is obtained However it has been found that vibration with a large amplitude as found in other products will not obtain a muscle motor response i e the muscle will not react In other words to be beneficial the vibratory amplitude must remain within normal physiological reactive range It has been found that because of the very high motor response without stress which occurs with cycloidal vibration muscles begin to react and perform in a very positive manner This is due to the use of cycloidal vibration having an effect on the muscle s electrical sensitivity i e after using cycloidal vibration on a muscle the muscle will react with less electrical input required In scientific studies the conclusion reached was that on human subjects the rheobase the lowest possible electrical impulse necessary to cause a muscle reaction was reduced by 20 after just fifteen minutes of cycloidal vibration application The benefits of this are of great importance for sports medicine and muscle toning allowing greater mobility especially with continued usage I use the NHC Cyclo Therapy Handheld Massager twice a day for six minutes in each hand and I have definitely noticed the benefits The massage function has improved the circulation and movement in my hands meaning I can firmly grip and pick up small items which I would have struggled with before Mrs Skinner Newcastle At the University of Brussels Medical Department research by Professor P Lievens demonstrated that cycloidal vibration energy effectively penetrates the human body and that The Cycloidal vibration acceleration rate is very low approximately twenty eight meters per second squared Other techniques of vibration can produce around one thousand two hundred and ninety meters per second squared That is about 50 x greater than a Cycloidal vibration generator This is what sets cycloidal vibration apart It is a Non Aggressive technique NHC Cyclo Therapy affect the muscles by way of stimulating mechano receptors in the muscles causing a very gentle contraction the intensity of a contraction is determined by the intensity of the stimulation A muscle spasm is a result of too much stimulation and muscle contraction Because the intensity of an electrical or tactile stimulation determines the intensity of the reaction or contraction of a muscle Research has found that vibration with high acceleration rate will cause too much stimulation and can stress traumatise or fatigue a muscle This is akin 10 11

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NHC Cyclo Therapy The Benefits CLINICAL PAPERS The following is a guide to cycloidal vibration therapy and refers to a small selection of the medical evidence from presented and published clinical trials and investigations Well over 50 clinical papers have been presented and published to date involving over 3000 testers and patients investigating the benefits Results of independent research show that the NHC Cyclo Therapy range of vibration applied in our products Generates pain relief Raises pain thresholds Soothes most rheumatic pains Can help rest and relaxation Help muscle relaxation Ease simple nervous tension Help to ease high and low back pains Improve local blood circulation Improve venous drainage Improve lymphatic drainage Help reduce swelling Improve joint mobility in most instances The body is a balanced system Changes in any one area can upset another and can alter the physiological balance this can lead ultimately to debilitating symptoms Symptoms that include Chronic or acute pain Tension and muscle spasm Poor circulation Poor venous or lymphatic drainage Although we cannot say that the use of our products are a cure for a specific medical condition NHC Cyclo Therapy combined with the positional adjustments of our products can help relieve common resulting symptoms Chronic and acute pain associated with Musculo Skeletal conditions Arthritis Rheumatism Frozen shoulder Tennis elbow 12 Staying Healthy at Home High low back pain Myalgia nerve pain Fibromyalgia Muscle pain pre and post activity Nervous system problems associated with Restless Legs Tension Anxiety Insomnia Circulatory problems associated with Oedema e g lower leg ankle and foot swelling Leg ulcers Poor circulation due to diabetes Walking pain Cold feet Respiratory problems associated with COPD Bronchiectasis Asthma Used by Professionals available for you at home At the West Yorkshire Physiotherapy Centre we work with a wide variety of musclo skeletal conditions from post operative orthopaedic problems to professional athletes sporting injuries We are actively using NHC Cyclo Therapy in the treatment of connective tissues within our range of professional massage techniques This promotes increased blood flow reduction in swelling decreased pain perception and as a result increased joint mobility and function Janine Midgley MCSP HCPC Grad Dip Phys Dip App Sports 13

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NHC Cyclo Therapy Reducing Pain When applied directly to or surrounding an area of pain NHC Cyclo Therapy is a non pharmacological aid to both generate pain relief or increase pain threshold The cycloidal vibration generates an anaesthetic effect to reduce pain HOW It is a sensory stimulant for parts of the nervous system that regulate the feeling of pain It stimulates through the skin and into the body the fast conducting large diameter myelinated A Belta fibres nervous system These in turn block the slower conducting nervous system that carry the pain signals As a result this then triggers inhibitory interneurons these control pain transmission resulting in pain relief or an analgesic effect and potentially raised pain threshold A Delta Nerve Fibers small A Beta Nerve Fibers large Projection Neurons Inhibitory neurons activated blocking projection neurons Pain is NOT Received 14 Many conventional pain relief stimulators deliver most of their relief directly under a small area such as contact electrode directly on the skin with a tens machine With NHC CycloTherapy this is delivered across a much larger area for example the whole surface of a bed chair or pad for that analgesic pain relief effect Staying Healthy at Home Reference Melzack R Wall PD Pain mechanism a new theory Published in medical journal Science 1965 150 971 978 Kandel ER Schwartz JH Jessell TM Published in medical journal Principles of Neural Science 4th ed pp 178 180 McGraw Hill New York 2000 NHC Cyclo Therapy compared to other means of pain relief include No pharmaceutical side effects Non invasive Deeper penetration into the tissues Larger surface area of application Stimulates skin and soft tissue blood flow Reduced inflammation and swelling Ease of use Pleasant experience 15

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Apply NHC Cyclo Therapy to these common forms of pain Various types of Musclo skeletal pain can be relieved by NHC Cyclo Therapy ranging from Arthritis Tendinitis Fibromyalgia Nerve pain Back and Joint pain Muscle pain Also help to prevent muscle soreness due to over activity Reduce Arthritis Pain Pain in the joints has been shown to be reduced considerably and in some cases eliminated on a repeat basis by the application of vibration therapy With arthritis it can cause the build up of metabolic waste material in the synovial fluid resulting in irritation and increased swelling inflammation in and around the joint Movement is accompanied by pain and reduced mobility due to limited joint flexion caused by inflammation It has been noted on many occasions following the application of cycloidal vibration that joint pain and swelling is reduced in turn resulting in improved joint and general mobility NHC Cyclo Therapy will not cure Arthritis but will help relieve symptoms such as pain swelling and joint mobility Key factors that can improve quality of life and general wellbeing RESEARCH Vibration therapy reduces chronic pain Research Published in the European Journal of Pain Vibration can help to ease certain types of pain by more than 40 percent Scientists at the University of Florida College of Medicine found that vibration produces an analgesic effect according to Dr Roland Staud a professor of rheumatology and clinical immunology at the institute Reference Roland Staud et al Attenuation of experimental pain by vibro tactile stimulation in patients with chronic local or widespread musculoskeletal pain European Journal of Pain February 2011 Helping Pain and Joint movement Scientist research shows that Muscle vibration helps knee movement in people with osteoarthritis Research published European Journal of Physical and Rehabilitation Medicine Reference Rabini A et al Effects of focal muscle vibration on physical functioning in patients with knee osteoarthritis a randomized controlled trial Eur J Phys Rehabil Med 2015 Oct 51 5 513 20 16 Staying Healthy at Home Improve Joint motion with osteoarthritis of the knee Professor Lievens demonstrated that knee flexion and extension movements both active and passive were significantly improved in patients with osteoarthritis of the knee compared to the control group that did not receive NHC CycloTherapy Lievens P Van De Voorde J 1984 The influence of cycloidal vibrations on the knee joint mobility of osteoarthritic patients Physiotherapy 70 6 241 243 Reduce Back Pain Both upper and lower back pain have been found to be considerably reduced due to NHC Cyclo Therapy Pain in almost all cases including radiating pain is reduced by the reduction of pressure from muscle spasm and or swelling on the nerves and reduction in muscle tightness NHC Cyclo Therapy CSTP Pad being used behind the back It has been noted on many occasions following the application of cycloidal vibration that joint pain and swelling is reduced in turn resulting in improved joint and general mobility Research has shown that when applied to the low back of patients with chronic lower back pain vibration therapy at the same levels as CycloTherapy can improve back and stomach muscle control and movement and may aid exercise that can help back muscle strength Reference Jean Alexandre Boucher et al The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients journal pone August 26 2015 1 17 As a company Adjustamatic and our NHC Cyclo Therapy beds work with Back Care a national charity working to reduce the burden of back and neck pain by providing information guidance and advice to all people and organisations affected by such pain 17

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Reduce Muscular and Nerve Pain Some forms of pain can be more complex and difficult to manage such as fibromyalgia or neuropathic pain NHC Cyclo Therapy cannot cure these conditions but for some may provide a relief for symptom pain Fibromyalgia is a disorder resulting in widespread musculoskeletal pain accompanied by fatigue sleep memory and mood issues Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals In some instances it may cause allodynia when you feel pain from something that should not be painful at all such as a very light touch In this instance NHC Cyclo Therapy is unlikely to help Nerve pain or neuropathic pain is a pain condition that s usually chronic It s caused by chronic progressive nerve disease this can be due to diabetes and it can also occur as the result of injury or infection It can flare up at any time without an obvious paininducing event or factor NHC Cyclo Therapy has shown to relieve pain symptoms for individuals with nerve pain RESEARCH NHC Cyclo Therapy and fibromyalgia Research by Pujol J in 2019 on 63 female patients with fibromyalgia was undertaken using vibration therapy Active intervention involved extensive body stimulation with gentle mechanical vibrations administered during 3hours at night for 3weeks and the placebo effect was controlled using identical instruments to simulate an alternative treatment option The primary outcome measure combined pain fatigue and complaints of poor cognition RESULTS Vibrotactile stimulation was significantly superior to sham in alleviating fibromyalgia symptoms globally Vibrotactile stimulation was notably well tolerated and sleep quality significantly improved despite the fact that vibrations were administered at night CONCLUSIONS Results thus provide new evidence that non nociceptive somatosensory stimulation may favourably act upon altered somatosensory balance in fibromyalgia From a clinical perspective both the degree of improvement and the easy application of our proposal would seem to support a potential role for vibrotactile stimulation in the symptomatic treatment of fibromyalgia Reference Pujol J et al Testing the effects of gentle vibrotactile stimulation on symptom relief in fibromyalgia Arthritis Res Ther 2019 Jun 14 21 1 148 NHC Cyclo Therapy and diabetic nerve pain Research by Stambolieva K in 2017 set out to evaluate the effectiveness of 8 week low frequency plantar under the feet vibration training on patients with diabetic peripheral neuropathy DPN PARTICIPANTS Twelve patients took part in the investigation RESULTS An increase of the nerve conductive velocity of soral and peroneal nerves of feet increased postural stability and disappearance of the pain and tingling were observed CONCLUSION The obtained results provide evidence for beneficial effects of 8 week plantar vibration training in patients with DPN Reference Stambolieva K et al Positive effects of plantar vibration training for the treatment of diabetic peripheral neuropathy A pilot study Mot Res 2017 Jun 34 2 129 133 18 Staying Healthy at Home Keeping track with the 21 DAY Record Chart How long will it take to feel an improvement or a continuous change This is dependent upon your condition and severity everyone is different In many instances you will feel an immediate difference or improvement straight away However from our research and consumer feedback it has been shown that with regular daily use the first 21 days is the average time taken to see the highest and most continuous improvement impact from using NHC CycloTherapy products Please complete your 21 day record chart this helps you to show how often you are using the product and the improvements and changes noted Send the 21 day record card back to us in the FREEPOST envelope provided for vital consumer feedback Week 1 WOifnonecrlgltcuehodtimsintopegafthigololetiwthyieolnoufnsirocgsattynhowauyetoeuyukso ecuaatnchnadernyetobhcueeorrreadfniprytyseotrfuoesrrdtedaipnanitdtlooyotiunmhsewapqgrhoeuavatoirnsftgeethtrytleiyonutpghrr eilDzirfeaoep ndy rt aw Use twice a day for anywhere between 10 15 mins at a gentle speed of 2 0 Date Please complete the below table following the sample shown Day Morning mins Speed Afternoon mins Speed Evening mins 1 10 min 1 5 10 min 1 5 10 min Speed 1 5 2 Itching to feel good Woaenaannxianstedhrtdirrhitvcnoaceeiwhtrsrhstei yeneuNroecrfiHinfoserasssmCact oeTwmCrneheoyogtiecfsnuhkltolesheao eeTssfrnpukhbsssieeaknaicnristnasigiiasoupwlN nlryyofhH awvieCnhceirleerelCtlhsttpytiotemhcsoleeuopienxp mTopctphhvraaeeeeensrarrdscalsteaap eigTmgyphs ehiel eliyiasuasomrpcluibteepahmesaueyinrnsaabieynganlsordegamxoapatpdhsrspetaeflareilitneonerbsdiwndealc osbtTecoiaoohaadcnnuniskfsttilthioiahcsnewrahgettisonahtyktghsaoai enssulUlecysirmnnaubnslprepraofaisrtalriloisomcanvneryeraioeemdlusaiadnys 3 4 5 6 these areas Clear the airways ICyTfCoyyhyucoicslrulooil sus TTunehhfgxefesterrr raeampampyoyleu b lnuyiilgninnsicaiotnoirpdgnmliadcnachigtleeiacodsnhntodeconsoprtynrbcoogrluveeeirasadrtuteaihposninpnicmegwer mphbhrieaceodchlbpkilayienootmgeruspyumohpyuoaypsyuebircfrmieacnaahldtyeehcvsfeaiitdnuemedsaneaescsyaieerybrloo yrfeuutathskoeeueoNpxfHpmtehCulescNpuHustCiunm 7 Comments No pain no gain 21 Days INrafmTIenennHyhfofuodlfCtiersseuhmxfccCeewllctieeayvfsioilsllcelrs mwslgmWoamtiebl eolmwTnoisrnhaeereoteedreeartadrkverchlati lwoassypittmeneioy itsmd hynfeepoooypabnrourosrltmtsooeuakasovbearuimedbylelpelcwpafel ilaayfwoigtetnnowehohsdcxi itifnncaeypDyghuleoeaeulsruwc rfaieeyiaesinltolwnsnhghooucoldruemteumhanassleeyeddoaosnsytystm hteootfiefiaeuonfsrrnfomadtwetmpthtsiuolyhslees affcaaisedtnlnsyeeewdmdlogaimtvtrmpchheehtuaeiuronectstmoshy2hcf os4elbToeueonhvhrstueeiootsmtrxeurluitirersun ss2nseececodw aslrU ueestessehiaaseikinsfrdsltgloyeibstoyrhuyoswceseoumasermrre uodfpssrfseicl edelteerely CONTRAINDICATIONS NHC Cyclo Therapy Cycloidal Vibration should not be used in the following circumstances if you have any of Or complete the record booklet online at www 21 DAY co ukthe following conditions5 Deep vein thrombosis Pulmonary embolism Aneurysm Active cancer Pregnancy Uncontrolled epilepsy Acute thrombophlebitis Osteomylitis 4 Post Back NHC Technology Colomendy Intrustrial Estate Rhyl Road Denbig2h1 LdLa16ys5ToSf NHC Cyclo Therapy later and we hope you are feeling much better Look back to day one and see how far you ve come you should CAUTION Do not use NHC Cyclo Therapy Cycloidal Vibration have more movement in your limbs be able to breathe easier and aches Directly against the chest or upper back if you have a pacemaker and pains should be reduced If you have an active infection and you are NOT receiving antibiotic therapy Don t forget to fill in the booklet and send it back to us to qualify for entry into the quarterly prize draw If you have unstable bone structures e g bone fragments Over an area of a recent joint replacement If the therapy has helped can you let us know in the box below We d love to use your feedback to help other people know about our products Comments Directly against an area of very severe osteoperosis Customer Service NHC Technology Ltd Colomendy Industrial Estate Rhyl Road Denbigh Denbighshire LL16 5TS UK Tel 44 0 1745 811200 Fax 44 0 1745 816106 DISCLAIMER All content is provided as a general overview on the ailments described and should not be used instead of seeking medical advice from your GP or other health care professionals Niagara Healthcare Ltd and group of companies is not responsible or liable for any diagnosis made from the content written in this document You should always consult your GP first with any health concerns The company accepts no responsibility for the misuse or misinterpretation of its products or the information provided Information provided is for guidance purposes only 50 Refer a friend and be rewarded Do you know someone who could benefit from an NHC Cyclo Therapy product Let us know and you will both be entered into our monthly draw to recieve a 50 Amazon Gift Card Please ask your friend or obtain their explicit consent to complete their details below or online Visit https www 21 day co uk terms and conditions Their Name We may wish to use the information provided in some of our marketing materials in the future This use will include but not be limited to marketing and promotional material to appear in press magazine broadcast inserts online and printed literature emphasising the benefits of NHC Cyclo Therapy and where relevant other associated products such as adjustable beds and riser recliner chairs If you wish to OPT OUT please tick here V02040121002000 Address Postcode Telephone 10 Post Back NHC Technology Colomendy Intrustrial Estate Rhyl Road Denbigh LL16 5TS Or complete the record booklet online at www 21 DAY co uk 11 19

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Apply NHC Cyclo Therapy to prevent pain BEFORE a daily busy routine or exercise Being overactive in daily routines such as exercise gardening and long walks can often lead to muscle pain or soreness a few hours later or the following day called DOMS Delayed onset muscle soreness DOMS is a symptom of exercise induced muscle straining or injury that is commonly encountered in athletes and fitness enthusiasts or if muscles are generally over worked If you have walked a little further or exercised a little more than normal then each movement beyond the capability of your muscles result in small microscopic ruptures within the muscle The subsequent healing of the ruptures creates the soreness due to the temporary changes caused in muscles unaccustomed to exercise Other such changes include decreased muscle strength reduced range of motion and muscle swelling during soreness and healing Ten research studies on over 258 people found that applying vibration therapy to the area of the body either before or after exercise can reduce muscle pain for up to 72 hours Reference Xingang Lu et al Does vibration benefit delayed onset muscle soreness a meta analysis and systematic review Journal of International Medical Research 2019 Vol 47 1 3 18 RESEARCH Vibration therapy for 20 minutes produced relief of chronic muscle pain that lasted at least 3 hours but in many cases 12 hours or more Reference Lundeberg T Vibratory stimulation for the alleviation of chronic pain Acta Physiol Scand Suppl 1983 523 1 51 Vibration Therapy has been shown to be more effective at reducing Pain when compared to a placebo therapy Published in the Medical Journal of Pain a study of 366 people with different forms of musculoskeletal pain ranging from extremity pain arthritis tendinitis nerve pain lower back pain and others 69 of people reported a reduction in pain due to vibration therapy 142 patients 64 had more that 50 reduction 58 patients 26 had complete relief To obtain maximum relief of chronic pain the therapy had to be applied for about 25 45 minutes with many reporting pain relief for 3 to 6 hours Reference Lundeberg T Nordemar R Ottoson D Pain Alleviation by Vibratory Stimulation Journal of Pain 20 1984 25 44 Vibration therapy can help with acute and chronic pain Published in medical journal Acta Physiologica Scandinavica Scandinavian physiology journal In a study on 731 patients 135 with acute pain 596 with chronic pain 20 Staying Healthy at Home Most of the patients had previously undergone treatments of various kinds without sufficient pain relief Vibration therapy for 20 minutes produced relief of chronic muscle pain that lasted at least 3 hours but in many cases 12 hours or more Reference Lundeberg T Vibratory stimulation for the alleviation of chronic pain Acta Physiol Scand Suppl 1983 523 1 51 Regular vibration therapy use to reduce pain can help long term research Published in medical Journal Pain All had suffered pain for 6 months to 8 years All had previously tried a range of analgesics and interventions to treat the pain with little effect 68 of 267 patients with chronic neurogenic nerve or musculoskeletal pain such as neuralgia low back pain myalgia tendonitis epicondylitis and rheumatoid arthritis had pain reduction due to vibration 59 had ongoing relief when followed up 18 months later indicating that induced pain relief may have long lasting effects Reference Lundeberg T Long term results of vibratory stimulation as a pain relieving measure for chronic pain Pain 1984 Sept 20 1 13 23 The Lancet medical journal editorial concludes the treatment of pain by vibration is simple safe and highly effective Reference Vibration therapy for pain Lancet 1992 Jun 20 339 8808 1513 4 21

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How to use NHC Cyclo Therapy to reduce pain 0 1 2 3 4 5 6 7 8 9 10 Where to apply the NHC Cyclo Therapy Apply directly to or adjacent to the area of the pain What speed of therapy should I apply NHC Cyclo Therapy for pain relief is often more effective at the medium to higher speeds We advise starting at a low to medium speed first between 2 and 4 so that your body gets used to the feeling of the therapy Once you are familiar with the therapy then you can build up to speeds 4 and above which are more effective for pain How long should I use the NHC Cyclo Therapy for Research shows you can start to feel a difference within 20 minutes of use we advise use for 30 minutes on average dependant on personal preference Why does the area feel slightly numb after use This can be part of the analgesic effect to reduce the pain How long will the pain relief last for Each person is different and pain levels type and cause of pain can vary significantly research shows however that Pain relief can last from anything from 1 to 6 hours dependant How often should I use the NHC Cyclo Therapy per day Apply when you most need it during the day it is most effective and convenient On average people use the NHC CycloTherapy 2 to 3 times a day What Are the Ideal NHC Cyclo Therapy Settings to help reduce my pain NOTE this is a guide please familiarise yourself with the product and use at the speeds and settings you are comfortable with and consider effective Product NHC Cyclo Therapy Hand Unit NHC Cyclo Therapy CSTP pad NHC Cyclo Therapy Bed NHC Cyclo Therapy Chair Application help reduce pain Speed Medium to High 3 to 9 4 to 9 4 to 9 22 Staying Healthy at Home NHC Cyclo Therapy HAS MADE SUCH A DIFFERENCE TO MY LIFE by Dr Ahmed practising GP Dr Ahmed told us I was an active practising GP in 2011 I was diagnosed with large multiple gastric tumours I had extensive surgery to remove them followed by chemotherapy Surgery left me with severe tissue damage and painful stomach scarring and I ended up walking with a stoop due to my scar pain This led to chronic back pain and a slipped disk A side effect of chemotherapy was joint pain and neuropathic pain in my fingers and hands My pain continued and I was on morphine anti inflammatories and daily tramadol to manage my back scar and neuropathic pain I was constantly lethargic and I could hardly work for the next 5 years I was introduced to NHC Cyclo Therapy by my private physiotherapist to use on my scarring and back to see if it could release the tethered tissues As a GP I was a little sceptical not knowing about NHC Cyclo Therapy but I was desperate to try anything After the first 5 x 30 minute therapy sessions there was a huge improvement There was a release and relaxation in my stomach muscles allowing me to walk straighter and without a stoop reducing my back pain With continued use of the Therapy I was nearly pain free and stopped all of my pain medication enabling me to work full time I cannot recommend it enough the difference it has made to me Examples Wound Pain Leg Ulcer Reduced lower leg wound pain as a result of NHC Cyclo Therapy Before and After Results published in the Medical Journal of Wound Care Reference 4 Wilson JM Arseculeranate YM Yang Y Cherry W Healing Ulcers with cycloidal multidirectional therapy Journal of Wound Care 11 No 9 Oct 2002 23

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Example Joint Pain Fibromyalgia Mr C is a 66 year old male and has suffered with muscular joint pain and fatigue in the back neck and upper and lower limbs for over 40 years Three years ago Mr C was diagnosed with Fibromyalgia he also suffers with polymyalgia spondylosis and arthritis Mr C suffers permanently with varying levels of back neck and shoulder pain this then affects both his arms and legs On an average day Mr C will take the following medication to help with his pain Tramadol TDS Paracetamol TDS and Amatriptaline OD Mr C however states he has pain all the time and that the analgesia only helps reduce its intensity Mr C has also experienced little or no pain reduction with acupuncture and TENS How was NHC Cyclo Therapy used The pad was used against the back and across the shoulders in the seated position over the area of pain The pad was applied 3 times a day for 30 minutes Result of use Mr C recorded changes in pain using a 0 10 visual analogue scale before and after applying the pad 0 1 2 3 4 5 6 7 8 9 10 BEFORE On average Mr C recorded a score of 8 AFTER On average Mr C recorded a score of 5 A reduction in pain and intensity was noted and this could last over 2 hours Mr C also stated that he found the product comfortable to apply and very easy to use It also helped with muscle relaxation I had more mobility in my neck and shoulders I found it very beneficial to reduce my pain first thing in the morning this made going out and daily activities more comfortable 24 Staying Healthy at Home USER CONVIENECE For ease of daily use our NHC Cyclo Therapy is built into our range of luxury therapy adjustable beds Used by Professionals now available for you at home NHC Cyclo Therapy products are used at specialist spinal injury centres across the country Occupational and physiotherapy use the therapy to relax tight muscles soften tissues reducing swelling and pain management 25

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Staying Healthy at Home Dealing with circulatory problems Poor circulation is common as we get older or become less active blood vessels become less elastic valves can start to fail and arteries can narrow or become blocked High blood pressure High cholesterol Diabetes Varicose Veins All can affect the blood vessels and restrict the normal flow of blood causing poor circulation Mobility in your legs is increasingly important as you age to maintain healthy circulation as your leg muscles help the circulation to your heart 26 Staying Healthy at Home Poor Circulation especially in the limbs and extremities can cause a range of problems not only cold numbness and tingling feet and hands but also Pain in legs and feet Pain and muscle cramps when walking Tired aching legs Swollen feet and lower legs Oedema Slow to heal foot and leg wounds ulcers Dry itchy pale skin NHC Cyclo Therapy has shown in research to improve blood flow and circulation How does NHC Cyclo Therapy increase circulation The non invasive application of NHC Cyclo Therapy vibration results in a process called mechano transduction the process of cells converting mechanical energy vibration into chemical activity The therapy penetrates into the vascular cells that line the blood vessels results in the stimulation of a number of chemical reactions This includes the release of the chemical nitric oxide this chemical is a natural relaxant of smooth muscle Nitric Oxide relaxes the smooth muscle walls of the blood vessels this can increase the diameter and size of the blood vessels veins and arteries resulting in dilation and allowing more blood to flow in the area treated with NHC Cyclo Therapy Reference Clinical Reference Sackner MA Gummels E Adams JA Mount Sinai Medical Center Miami Beach USA Nitric Oxide is released into circulation with wholebody periodic acceleration 127 30 39 2005 Published in Chest Official medical Journal of the American college of Chest Physicians 27

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Nerve Nerve signal NHC Cyclo Therapy Blood vessel Endothelial cells Constricted smooth muscle cell Nitric oxide NO gas Smooth muscle Larger blood vessel Relaxed smooth muscle cell RESEARCH Research shows an increase in blood vessel flow and diameter observed in skin and soft tissue after 10 minutes in the following study Influence of cycloidal vibration on skin blood flow changes observed in an invivo microcirculatory model Reference Professor Pierre Lievens Head of the department of Medical Rehabilitation Research Faculty of Medicine Vrije Universiteit Brussels Presented at Wounds UK medical conference Autumn 2011 Before 28 After 10 minutes of cycloidal vibration Note the enlarged blood vessels due to the dilation reaction caused by NHC Cyclo Therapy Staying Healthy at Home Increase in blood flow due to the non invasive application of cycloidal vibration has been shown in numerous ways including measurement by Laser Doppler imaging and plethysmography Laser Doppler imaging In 2001 Professor T Ryan and colleagues at the Oxford Wound Healing Institute Oxford Brookes University and Churchill Hospital measured blood flow in skin soft tissue of adults with Laser Doppler Ultrasound before and after NHC Cyclo Therapy They found that it recorded a consistent increase in blood supply following cycloidal vibration Reference Ryan et al The effect of mechanical forces vibration or external compression on the dermal water content of the upper dermis and epidermis assessed by high frequency ultrasound Journal of tissue viability 2001 Vol 11 NO 3 Before After The blood flow is shown as the green and yellow area by scanning with Laser Doppler imaging before and after cycloidal vibration Research comparing vibration to a placebo no treatment on the blood flow of the lower legs found an increase in peripheral blood flow of 14 compared to the placebo Peak blood flow occurred after 22 minutes of vibration therapy Reference Button C Anderson N Bradford C et al 2007 The effect of multidirectional mechanical vibration on peripheral circulation of humans Clin Physiol Funct Imaging 27 pp211 216 Research undertaken at the department of physical therapy at Chicago University in 2018 shows that placing your feet on to a low intensity vibration surface as per an NHC Cyclo Therapy pad or Hand Unit will produce acute increases in skin blood flow Reference Yi Ting Tzen et al Increased skin blood flow during low intensity vibration in human participants Analysis of control mechanisms using short time Fourier transform PLOS ONE https doi org 10 1371 journal pone 0200247 July 12 2018 29

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Lymphatic system is part of the circulation 90 of fluid in the body is circulated by blood vessels and 10 by the lymphatic system as the body s overflow system Lymphatics are vital in removing excess fluid and swelling oedema as they remove not only fluid but also the larger particulate matter such as proteins microphages and metabolic waste material which cannot be removed via the blood capillary system Before After The Lymphatic vessel is highlighted with blue dye before and after 10 minutes of cycloidal vibration Clearly visible in the after photograph is dilation of the lymphatic flow due to NHC Cyclo Therapy Reference Influence of Cycloidal Vibration on lymphatic flow and changes observed in lymphatic vessels Professor P Lievens Head of the department of Lymphoedema Research Vrije Universiteit Brussel presented Wounds UK 2008 medical conference Staying Healthy at Home NHC Cyclo Therapy Reducing Oedema The combined effects of stimulating blood flow and the lymphatics can help reduce the symptoms of Oedema lower leg ankle and foot swelling Swollen feet ankles and Lower Legs Oedema Swelling Oedema is an abnormal accumulation of fluid this can occur beneath the skin or in deeper tissues Swelling of the foot ankle and lower leg can be common results and is often known as water retention It is often caused by circulatory problems either directly or as a result of heart problems varicose veins venous hypertension lymphoedema or a range of health conditions and poor mobility RESEARCH A study by Dr Cherry published in the Journal of Wound Care in 2002 showed that the application of cycloidal vibration showed up to a 15 reduction in leg limb volume or swelling when applied daily Reference Wilson J Arseculeratne YM Yang Y and Cherry GW Oxford Wound Healing Institute Churchill Hospital Oxford Journal of Wound Care Vol 11 NO 9 October 2002 A study by wound care specialists and the vascular department at a UK hospital in 2007 showed that patients with lower leg skin infections and leg swelling having bed rest alone for a period of seven days had an average reduction in lower leg circumference and swelling of 2 3 This compared to an average reduction of 6 6 for patients having bed rest and cycloidal vibration Reference Johnson S et al Can cycloidal vibration plus standard treatment reduce lower limb cellulitis treatment times Results from a randomised controlled trial Journal of Wound Care Vol 16 No 4 April 2007 Bed rest can help reduce swelling in the legs but combined bed rest with NHC Cyclo Therapy has shown to be twice as effective for swelling reduction 30 31

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mean reduction in limb circumference by day 7 8 7 6 5 4 3 2 1 0 NHC Cyclo Therapy Standard Treatment Reduction over 7 days NHC Cyclo Therapy reducing leg swelling examples Reduce lower leg swelling BEFORE and AFTER 7 days of NHC Cyclo Therapy Mrs C had severe leaky ulcerated lower leg oedema with a calf circumference at start of 47cm after using an NHC CycloTherapy pad under her leg 3 x times a day for 20 minutes her leg swelling reduced by over 20 and her ulcers started to heal A heavily sprained ankle with bruising had resulted in severe swelling of the ankle NHC Cyclo Therapy was applied with the hand unit to help reduce the swelling Using NHC CycloTherapy combined with massage there was an immediate effect Staying Healthy at Home NHC Cyclo Therapy Effects on circulation Diabetes How can it help my leg circulation and health If you have diabetes or arterial disease you are at risk of changes that can affect your health and mobility Peripheral arterial disease and diabetes can affect blood flow and circulation particularly to your legs and feet Blood vessels can narrow or become blocked This can cause Muscle cramps and pain when walking called intermittent claudication Reduced walking distance due to pain If smaller diameter blood vessels become damaged by diabetes treatment options are limited Leg and foot wounds can become difficult to heal In worst cases poor circulation and non healing wounds due to arterial disease and diabetes can lead to severe infection and risk of amputations HEALTHY Circulation HEALTHY Legs and better walking and mobility NHC Cyclo Therapy has been shown to increase blood flow to help improve walking without pain NHC Cyclo Therapy CSTP Pad being used under the legs to increase blood flow Before After 20 mins of Therapy Before After 20 mins of Therapy 32 33

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NHC Cyclo Therapy increasing leg blood flow Diabetes With Diabetes it is important to look after your general circulation and your skin blood flow health in particular to your legs and feet Complications of diabetes contributes to the blocking of arteries and reduced blood flow Using NHC Cyclo Therapy can help to improve and maintain healthy blood flow in these areas RESEARCH In clinical research published in the medical journal Diabetes Technology in 2009 carried out at the Department of Physical Therapy Loma Linda University California skin blood flow was measured and compared in age matched healthy older adults to adults with type 2 diabetes when both groups were submitted to vibration therapy A significant increase in blood flow was seen in both the healthy and diabetic groups There was an increase in blood flow in the diabetic group but it was less than in the healthy group As already described diabetes can result in the thickening of blood vessel walls that can impede dilation of the smooth vascular muscle wall of vessels reducing blood flow However the increase in blood flow in the diabetics due to vibration would still have circulatory benefits Reference Maloney Hinds C Petrofsky JS Zimmerman G Hessinger DA 2009 The role of Nitric Oxide in skin blood flow increases due to vibration in healthy adults and adults with type 2 diabetes Diabetes Technology and Therapeutics 11 1 39 43 A medical study by Ren in 2019 stated that poor blood flow supply is an important factor that leads to the development and deterioration of diabetic foot ulcers This study aimed to investigate the acute effects of local vibration on underside of the foot skin blood flow in 11 diabetics compared to 15 healthy people Results showed that the diabetics had increased blood flow in both vibration and post stage These findings suggest that local vibration of the feet may effectively improve skin blood flow in the feet of diabetic people Reference Ren W et al Effects of Local Vibration With Different Intermittent Durations on Skin Blood Flow Responses in Diabetic People Front Bioeng Biotechnol 2019 Nov 5 7 Staying Healthy at Home Used by Professionals available for you at home Commenting on the use of NHC Cyclo Therapy Katie Ormerod World cup winner and Olympic snowboarder said As a freestyle snowboarder I have to have the flexibility and control of a gymnast to undertake aerial tricks A fall on the snow can cause lots of soft tissue injury NHC Cyclo Therapy is really helping me to recover quicker after a hard session of training or injury I am using the therapy pre and posttraining sessions and competition I have found the NHC Cyclo Therapy Pad has been effective in relieving the pain I experienced because of a broken elbow and the subsequent aches in my hand The massage system has encouraged circulation and general mobility I am really impressed by the difference I have felt through using the Therapy Pad Mrs Jackson Norfolk 36 37

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NHC Cyclo Therapy Effects on healing wounds To stimulate the 4 stages of healing of a wound or tear injury you need the supply of effective blood flow Without that blood flow healing can take longer and additional risk of complications can occur Blood vessels need to open to allow fresh nutrients and oxygen into the wound for healing processes to take place There are many types of wounds that may benefit in healing from the application of NHC CycloTherapy and these can include Leg Ulcer Diabetic wound Pressure wound Tendon or Muscle tear wound Stages of Wound Healing Bleeding Inflammatory Proliferative Remodelling RESEARCH Leg Ulcers Research shows that applying NHC Cyclo Therapy to the lower legs can increase blood flow which in turn will stimulate healing and cell regeneration This can improve the healing of soft tissue injury and wounds like leg and foot ulcers A study by Dr Cherry published in the Journal of Wound Care in 2002 showed that the application of NHC Cyclo Therapy 3 times a day for 30 minutes in conjunction with bandaging can stimulate the healing of hard to heal venous leg ulcers Patients on the trial had their leg ulcers for an average of 8 months duration They can be defined as hard to heal Outcomes included 62 of the patients receiving cycloidal vibration to the lower leg healed within 12 weeks and of the rest all showed a 31 90 improvement in healing Using cycloidal vibration to stimulate lower leg circulation in combination with traditional forms of treatment reduces healing times It not only improves patient outcomes but also their quality of life by reducing pain 38 Staying Healthy at Home An 84 year old female with a venous leg ulcer received standard treatment for six weeks showing no improvement After using cycloidal vibration for four weeks scabs formed and the ulcer was healed during week six Before After Reference Wilson J Arseculeratne YM Yang Y and Cherry GW Oxford Wound Healing Institute Churchill Hospital Oxford Journal of Wound Care Vol 11 No 9 October 2002 RESEARCH Diabetic Wound Research by Hesham G in 2013 stated diabetic foot complications are the most frequent reason for hospitalization in patients with diabetes Together with vascular disease in the legs neuropathy contributes to the risk of diabetes related foot problems such as diabetic foot ulcers that can be difficult to treat and occasionally require amputation Early detection and appropriate treatment of these ulcers may prevent up to 85 percent of amputations The study set out to detect the effect of low mechanical vibration on healing of diabetic foot ulcer 29 diabetic patients with type 2 diabetes suffer from diabetic ischemic foot ulcer were divided into 2 groups 1st group received low mechanical vibration for 15 minutes 3 x day for up to 4 weeks and a control group received no treatment Results showed in the vibration group there was significant reduction in size of the ulcer after two weeks of treatment this continued for the 4 weeks Compared to no significant difference in the un treated control group The study concluded that low mechanical vibration may improve healing of diabetic foot ulcer Reference Hesham G et al Effect of Mechanical Vibration Therapy on Healing of Foot Ulcer in Diabetic Polyneuropathy Patients Journal of American Science 2013 9 7 39

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Example Prodiatry Birmingham Community NHS Trust Start Diabtic ulcer big toe for 9 months After 30 weeks using the NHC Cyclo Therapy Pad ulcer healthy and healed Male age 63 Diabetic 12 years Small cut developed into a wound on the first toe subsequent diagnosed as ischemic a lack of adequate arterial blood flow to the area to help healing Due to lower limb critical ischemia preventing blood flow angioplasty took place but was un successful The vascular consultant offered consideration of lower limb amputation as their only option as healing was highly unlikely A diabetes specialist podiatrist had been managing the wound for 9 months prior to commencing NHC Cyclo Therapy This was applied for two weeks and the wound showed signs of improvement The lower limb tissues looked healthier with improved blood flow The decision was made to continue the treatment as the wound was improving and healing At 30 weeks the wound was virtually healed and as a result of the improvement the patient s mobility mental health and subsequent general quality of life had improved The risk of potential amputation had been avoided Example Specialist wound care Doncaster Royal Infirmary NHS Trust Chronic wounds are a major burden to both patients and the NHS these include diabetic foot ulcers that are complex and have a high risk of wound complication NHC Cyclo Therapy has been used as an adjunct to increase tissue blood flow and to heal chronic wounds This case study record s the experiences of applying the therapy to a non healing high risk diabetic plantar foot wound of 7 months duration treated with standard methods to date The patient had below knee arterial disease unsuitable for surgical intervention The patient self applied the therapy three times a day in combination with ongoing standard treatment of dressings and offloading resulting in the plantar wound healing by week 6 Reference Johnson S et al Wound Care Team Doncaster Royal Infirmary Cycloidal Vibration Vibro Pulse treatment of post surgical diabetic lower limb wound Presented at Wounds UK 2012 conference Fig 1 Fig 2 Fig 3 Fig 4 Start Mr S had a recent post surgical wound to the top off his left foot as a result of the removal of metatarsal bone fig 1 and a plantar ulcer of 7 months duration fig 2 By week 6 The plantar ulcer had healed fig 3 The post surgical wound top of the foot continued to heal fig 4 fully healing at week 9 40 Staying Healthy at Home RESEARCH Tendon Tear Published Research in 2019 on a clinical study that set out to evaluate the effects of vibration on Achilles tendon microcirculation and change in rehabilitation characteristics following surgical repair of Achilles tendon rupture 32 patients with an average age of 43 years had vibration application to the ball of the foot 30Hz 2mm amplitude 4kg pressure and selfadministration this was applied daily Main outcome measurements tendon blood microcirculation was measured and tendon stiffness 3 functional outcome tests and a questionnaire survey Results showed that the acute effects of the vibration were observed immediately after 5 minutes vibration Lower total haemoglobin and oxygen saturation were respectively observed in the repaired legs 3 and 6 months post surgery in the vibration group The vibration group also showed greater tendon stiffness heel raising height and hopping distance 3 or 6 months post operation in both the repaired and non injured legs The microcirculatory characteristics at 2 months post operation and vibration were correlated with the outcomes at 6 months post operation IN CONCLUSION differences in microcirculatory characteristics and better rehabilitation outcomes were observed in the legs with an Achilles repair that underwent the early vibration intervention Reference Pei Yun W et al Acute and Long Term Effects of Mechanotherapy on the Outcome After an Achilles Repair A Prospective Cohort Study With Historical Controls Arch Phys Med Rehabil 2019 Nov 100 11 2046 2052 RESEARCH Healing Pressure Wound Ulcers Published Research in 2010 investigated whether vibration therapy could facilitate the healing of Stage I pressure ulcers PrUs in older adults The study was on hospital patients in long termcare facilities with Stage I PrUs In the experimental group vibration was applied for 15 minutes 3 times a day for up to 7 days until Stage I PrUs healed Apart from the vibration therapy the vibration and control groups received the same care which was provided according to PrU care guidelines The number of healed ulcers was compared between 2 groups RESULTS The vibration group consisted of 16 patients with 20 Stage I PrUs the control group consisted of 15 patients with 21 Stage I PrUs In the vibration group 40 0 healed compared to 9 5 in the no treatment group The healing rate during the study period was significantly higher in the vibration group than in the control group The mean relative changes per day in wound area and intensity of redness were significantly greater in the vibration group than in the control group IN CONCLUSION Based on these results the use of the vibration may facilitate the healing of Stage I PrUs Reference Arashi M et al Vibration therapy accelerates healing of Stage I pressure ulcers in older adult patients Adv Skin Wound Care 2010 Jul 23 7 321 7 41

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How to use NHC Cyclo Therapy to Increase my Circulation Reduce Swelling or Heal a Wound Where to apply the NHC Cyclo Therapy Apply directly to or adjacent to the area of where you wish to increase circulation For example under your upper or lower legs as shown or under your feet If you have a wound DO NOT REMOVE any dressings and bandaging DO NOT apply directly to the wound What speed of therapy should I apply NHC Cyclo Therapy for increasing circulation is often more effective at the lower to medium speeds We advise starting at a speed between 1 5 and 3 5 or low to medium for a hand unit Research shows these speeds increase blood flow How long should I use the NHC Cyclo Therapy for Research shows you can start to feel a difference within 20 minutes of use Why does the area feel hot or throbbing during and after use A throbbing feeling or it feels hot or the skin is flushed and red are the effects of increasing circulation How long will the increase in blood flow last for Each person is different and research shows the increase occurs during use and for up to 1 hour after in the first instance The aim with daily use is to see an accumulative change and improvement How often should I use the NHC Cyclo Therapy per day On average people use the NHC Cyclo Therapy 2 to 3 times a day 42 Staying Healthy at Home What are the ideal NHC Cyclo Therapy settings to increase my circulation NOTE this is a guide Please familiarise yourself with the product and use at the speeds and settings you are comfortable with and consider effective Application increase circulation reduce swelling heal a wound Product Speed NHC Cyclo Therapy Hand Unit Low to Medium NHC Cyclo Therapy CSTP pad 1 5 to 4 5 NHC Cyclo Therapy Bed 2 to 5 NHC Cyclo Therapy Chair 2 to 5 USER CONVIENECE For ease of daily use our NHC Cyclo Therapy is exclusively built into our range of adjustable chairs 43

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NHC Cyclo Therapy Helping to relax muscles for stroke patients We use the NHC Cycloidal Vibration Therapy CVT hand unit with stroke patients that suffer with increased tone and muscle spasticity muscle stiffness We have tried other sensory vibration products before with little effect The CVT hand unit really helps to free up the muscles in these patients to improve joint proprioception and improved flexion and extension after only 5 minutes use The treatment has given enormous physical functional and mental gains to stroke patients Physiotherapist Kelly Aelberry Hospital Stroke Team Physiotherapists at Leicester General Hospital Epidermis Dermis Hypodermis Bone 44 Blood Vessels Nerves Muscle Staying Healthy at Home Staying Healthy at Home Muscle relaxation and stimulation NHC Cyclo Therapy affects the muscles by way of stimulating mechano receptors in the muscles causing a very gentle contraction the intensity of a contraction is determined by the intensity of the stimulation A muscle spasm is a result of too much stimulation causing muscle contraction Because the intensity of an electrical or tactile stimulation determines the intensity of the reaction or contraction of a muscle Research has found that vibration with high acceleration rate will cause too much stimulation and can stress traumatise or fatigue a muscle This is akin to straining or stressing a muscle which will then produce additional metabolic waste in an area This can cause soreness and swelling with too much load on the lymphatic system With NHC Cyclo Therapy delivering small amplitude and low acceleration very high muscle motor response is obtained However it has been found that vibration with a large amplitude as found in other products will not obtain a muscle motor response i e the muscle will not react In other words to be beneficial the vibratory amplitude must remain within normal physiological reactive range It has been found that because of the very high motor response without stress which occurs with NHC Cyclo Therapy muscles begin to react and perform in a very positive manner This is due to having an effect on the muscle s electrical sensitivity i e after using on a muscle the muscle will react with less electrical input required In scientific studies the conclusion reached was that on human subjects the rheobase the lowest possible electrical impulse necessary to cause a muscle reaction was reduced by 20 after just fifteen minutes of cycloidal vibration application The benefits of this are of great importance for sports medicine and muscle toning allowing greater mobility especially with continued usage Reference Guang H et al Focal Vibration Stretches Muscle Fibers by Producing Muscle Waves IEEE Trans Neural Syst Rehabil Eng 2018 Apr 26 4 839 846 45

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When applied directly to or surrounding an area of tight or sore muscles NHC Cyclo Therapy is a non pharmacological aid to generate muscle relaxation and stimulation This can help increase joint movement and rotation if tight muscles prevent movement The cycloidal vibration generates a relaxation effect on the muscle HOW Tonic Vibration Reflex l motor neurone Higher centres a motor neurone MUSCLE Muscle spindle Joint mechanoreceptors GTO Vibratory stimulus In what circumstance will NHC Cyclo Therapy help relax or stimulate my muscles a If you over work your muscles with strenuous activity such as too much gardening exercise or walking The next day muscles can be tight and sore reducing movement DOMS Delayed Onset Muscle Soreness b If you suffer with a medical condition or trauma that results in tight muscles otherwise known as high tone or spasticity such as a stroke spinal cord injury cerebral palsy multiple sclerosis and Parkinson s disease RESEARCH Extracts Muscle Stimulation effecting joint mobility in knee osteoarthritis published research by Lievens P describes a study conducted on an NHC Cyclo Therapy and non therapy group to show the influence of cycloidal vibrations on the knee and joint mobility of osteoarthritis patients Although the results did not show that one treatment of NHC Cyclo Therapy had an effect on mobility a significant increase in mobility was shown after ten days of Therapy Reference Lievens P Van De Voorde J The influence of Cycloidal Vibrations on the Knee joint mobility of Osteoarthritic Patients Physiotherapy June 1984 vol 70 no 6 Muscle relaxation stimulation of muscles change in balance in the elderly published research by Attansio G 2018 reported a study set to demonstrate the effects of focal direct to muscle vibration on the elderly Imbalance in elderly is a common problem strictly related to fall This study investigates the possibility that focal direct mechanical muscle vibration may improve balance and stability Patients referring with poor balance were treated with focal muscle vibration applied to quadriceps muscles and evaluated before and immediately after therapy and after 1 week and after 1 month with postural stability examination and with an inertial measurement unit during the time up and go test Stability analysis showed statistically 46 Staying Healthy at Home significant differences in both the area and sway of the center of pressure during the closed eye tests The time of the time up and go test was reduced and the rotation velocity was increased IN CONCLUSION The findings confirm the beneficial role of focal muscle vibration in elderly patients improve postural stability and mobility Reference Attanasio G et al Does focal mechanical stimulation of the lower limb muscles improve postural control and sit to stand movement in elderly Aging Clin Exp Res 2018 Oct 30 10 1161 1166 Muscle stimulation relaxation treatment for after effects of Stroke Published research by Annino G in 2019 studied the upper extremity functional impairments which are a common consequence of a stroke Focal direct muscle vibration is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability The aim of this study was to investigate the influence of 5 minute muscle vibration along with supervised physical therapy on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke A sample of 37 patients poststroke 29 males was randomly allocated to either physical therapy control group or physical therapy and muscle vibration experimental group All patients received 3 sessions per week for 8 weeks Outcome measures used were Barthel index BI modified Ashworth scale manual muscle testing and goniometry for range of motion ROM assessment RESULTS 34 patients completed the study Patients in both groups improved significantly after treatment in BI elbow ROM and elbow muscles strength However muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after muscle vibration only in the experimental group IN CONCLUSION Muscle vibration can improve functional outcomes of upper extremity in people after stroke However it may have superior effect on improving muscle tone after stroke Reference Annino G et al Effect of segmental muscle vibration on upper extremity functional ability poststroke A randomized controlled trial Medicine Baltimore 2019 Feb 98 7 Muscle stimulation relaxation treatment after exercise induced muscle damage Published research by Stebbings G in 2021 stated that previous research on vibration therapy reports modulation in muscle blood flow oxygenation and strength The aim of this study was to observe if local vibration therapy alleviates the impairments and haemodynamic changes associated with Exercise Induced Muscle Damage EIMD Ten healthy participants were randomized into experimental vibration therapy and control no therapy groups Both groups 47

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perform 10 sets of 10 eccentric wrist flexions at 70 of 1 repetition maximum to induce muscle damage Subsequent assessment of wrist flexor strength and flexor carpus ulnaris FCU muscle oxygen saturation SmO2 occurred at 1 24 and 48 hrs post exercise The vibration therapy group underwent 10 min of local therapy at 45 Hz starting 1 hr post exercise and applied twice daily separated by 8 hrs for 48 hrs during habitual waking hours Main measurements were grip strength resting muscle oxygen SmO2 muscle oxygen de saturation and re saturation rate Results No difference in grip strength observed pre EIMD but the vibration therapy group demonstrated greater strength at 1 hr 24 hr and 48 hr post EIMD compared to no therapy No difference in SmO2 re saturation over time but the vibration therapy group had a greater resaturation rate compared to controls at 1 hr 24 hr post EIMD Conclusions Local vibration therapy successfully attenuated the effects of EIMD and increased SmO2 re saturation in muscles Including this as part of a recovery protocol post EIMD could be beneficial for rehabilitation and athletic training purposes Reference S Percival D T Sims G K Stebbings J Athl Train 2021 Aug 17 Local vibration therapy increases oxygen re saturation rate and maintains muscle strength following exercise induced muscle damage NHC Cyclo Therapy Helping to Relax Muscles for Athletes Rebecca Campsall was a 26 year old sprinter training at the English Institute of sport a Yorkshire champion and twice medalled at Northern Championships as well as making the final of the England Championships Rebecca slashed her 100 metres personal best and by doing so is knocking on the door of the Great Britain athletics team Rebecca has recieved treatment with the NHC Cyclo Therapy Hand Unit massage This would release the deeper scar tissue and fascia without causing bruising trauma or excessive soreness Rebecca stated my soft tissue and muscle recovery has really improved since starting to use the therapy I am now starting to use it to help recovery after racing 48 Staying Healthy at Home How to use NHC Cyclo Therapy to Relax and Stimulate my muscles Where to apply the NHC Cyclo Therapy Apply directly or adjacent to the area of the muscles you wish to treat For example under your thighs calves arm or behind your back What speed of therapy should I apply NHC Cyclo Therapy for muscle stimulation relaxation is often more effective at the site of the tight muscle or muscle soreness or adjacent to it Speed to use can vary dependant on your build and the muscle area applied The ideal speed is above low to the higher speed range to stimulate tonic vibration reflex How long should I use the NHC Cyclo Therapy for Research shows you can start to feel a difference within 20 to 30 minutes of use How long will the muscle relaxation stimulation last for Each person is different and research shows that the change can last for up to 6 hours post use The aim with daily use is to see an accumulative change and improvement How often should I use the NHC Cyclo Therapy per day On average people use 2 to 3 times a day What Are the Ideal NHC Cyclo Therapy Settings to relax or stimulate my muscles NOTE this is a guide Please familiarise yourself with the product and use at the speeds and settings you are comfortable with and consider effective Application increase circulation reduce swelling heal a wound Product Speed NHC Cyclo Therapy Hand Unit Medium to High NHC Cyclo Therapy CSTP pad 3 to 9 5 NHC Cyclo Therapy Bed 3 5 to 9 NHC Cyclo Therapy Chair 3 5 to 9 49

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NHC Cyclo Therapy Helping former Olympians Recover Irish Olympic event rider Jonty Evans is making remarkable progress after a fall from his horse in competition at Tattersalls in 2018 that left him with a serious brain injury and in a coma for 6 weeks As part of his rehabilitation therapy Jonty is now benefiting from using the NHC Cyclo Therapy hand unit and Pad It helps relax his high tone stiff and sore muscles due to his injury When I applied the NHC Cyclo Therapy pad behind my back and under my legs I could feel a real difference in the relaxation and stretch in my muscles enabling me to move my hip and joints with greater movement I was really surprised Jonty Evans Irish Olympian 50 Staying Healthy at Home Staying Healthy at Home Restless Legs Syndrome nervous system Restless Legs Syndrome RLS is characterised by unpleasant sensations that occur mostly in the legs Severity of RLS can vary widely from mild to extreme it includes an urge to move the legs These sensations are often described as itching under the skin or a tingling creeping crawling feeling RLS is also known as Willis Ekbom Disease WED a neurological disorder RLS is a common disorder that affects people of all ages however its prevalence increases with age These sensations tend to begin or worsen during periods of rest or inactivity such as lying or sitting and can be partially or totally relieved by movement such as walking or stretching at least as long as the movement continues Most people experience symptoms in the evening while they are in bed trying to fall asleep Many individuals with moderate to severe primary RLS experience disruptive sleep that can cause poor sleep quality This can lead to disrupted work and family life moodiness and feelings of tiredness or drowsiness during the day References Hening W Allen R et al The treatment of restless legs syndrome and periodic limb movement disorder An American Academy of Sleep Medicine Review Sleep 22 970 999 1999 Yoakum RH Restless legs syndrome Relief and hope for sleepless victims of a hidden epidemic New York Fireside 2006 NHC Cyclo Therapy reducing the unpleasant feelings of RLS and helping sleep Applying NHC Cyclo Therapy to the lower legs generates a counter stimulation applying a specific range of vibrations to overwhelm the sensations that are felt in the legs during an RLS attack When placed at or near the site of discomfort commonly the calf or thigh vibratory counter stimulation can interrupt an RLS attack and distract from the uncomfortable RLS sensory experience and relieving the symptoms 51

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The leg has a range of somatic sensory receptors highly specialised cells associated with neurons that convert various forms of energy from a physical stimulation into nerve impulses This can be achieved with a CSTP therapy pad or ideally within the foot section of an NHC CycloTherapy bed or chair While lying down this may allow the user to relax and fall to sleep quicker and easier Staying Healthy at Home Patients were randomly assigned to treatment with a vibrating pad or control no therapy sham pad Efficacy was measured as a change in score from baseline to week 4 on the Medical Outcomes Study Sleep Problems Index II the Johns Hopkins Restless Legs Syndrome Quality of Life summary scale and the International Restless Legs Syndrome Study Group rating scale RESEARCH Extracts Using the NHC Cyclo Therapy pad to Reduce symptoms of Restless Legs syndrome RLS Research presented by Rayner J 2017 at the Respiratory Support and Sleep Centre RSSC Papworth Hospital Cambridge stated that patients with moderate to severe RLS may not tolerate or respond to first line pharmaceuticals An evaluation to investigate the role and efficacy of NHC Cyclo Therapy in the management of treatment refractory RLS was carried out Method All patients had a clinical diagnosis of RLS and had failed to respond to or tolerate standard conservative treatment Patients attending outpatient clinic were provided with a NHC Cyclo Therapy pad for a four week trial period Effectiveness was assessed before and after using Epworth Sleepiness Score ESS International Restless Legs Syndrome Rating Scale IRLSRS Self reported Sleep Latency SL Self reported Total Sleep Time TST Clinical Global Impression Severity CGI S 0 10 10 worst symptoms 45 patients 20 male 25 female average age of 63 8 years completed the trial The therapy caused a statistically significant reduction in IRLSRS an increase in TST stabilisation in CGI S score IN CONCLUSION 42 of patients completing a four week trial of NHC Cyclo Therapy treatment reported a noticeable improvement in their symptoms NHC Cyclo Therapy can offer an alternative and effective non pharmacological treatment for patients with refractory RLS Reference Rayner J et al The use of Vibrating Therapy Pads in treatment resistant Restless Legs Syndrome Respiratory Support and Sleep Centre Papworth Hospital NHS Foundation Trust Papworth Everard Cambridgeshire CB23 3RE Presented at the British Society of Sleep Biennial Scientific Meeting 2017 Using a vibration therapy pad to Reduce symptoms of Restless Legs syndrome RLS to improve sleep A study published in 2013 on 158 patients with at least moderately severe primary restless legs syndrome a score of 15 or greater on the International Restless Legs Syndrome Study Group rating scale 52 Bar graph showing greater clinical improvement for patients assigned vibrating pads Bar graph showing greater sleep improvement in MOS ii scores from baseline for patients assigned a vibrating pad _1 SeM bars Abbreviations MOS ii Medical Outcomes Study Sleep Problems index ii SeM standard error of the mean The Medical Outcomes Study Sleep Problems Index II scores improved significantly more for patients receiving a vibrating pad over those receiving a sham pad IN CONCLUSION Four weeks of treatment with vibrating pads safely improved sleep in patients with restless legs syndrome compared to a sham therapy Reference Burbank F et al Sleep improvement for restless legs syndrome patients Part 1 pooled analysis of two prospective double blind sham controlled multi center randomized clinical studies of the effects of vibrating pads on RLS symptoms Journal of Parkinsonism and Restless Legs Syndrome 2013 3 1 10 How to use NHC Cyclo Therapy to reduce the symptoms of Restless Legs Syndrome Where to apply the NHC Cyclo Therapy Apply directly or adjacent to the area of the legs where you get the RLS feelings What speed of therapy should I apply Dependant on the severity of your RLS please experiment with speed settings until you get the balance of both comfort combined with the reduction in RLS sensations This will vary person to person 53

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How long should I use the NHC Cyclo Therapy for Research shows you can start to feel a difference within 20 to 30 minutes of use Why does the area feel numb after use This is the result of the counter stimulation effecting the nerves creating an analgesic sensation How long will this last for Each person is different and research shows this may not last long or for hours after use The aim is to reduce the RLS sensations enabling you to fall to sleep How often should I use the NHC Cyclo Therapy per day Apply when you feel you need to counter your RLS sensations this is mainly in the evening What Are the Ideal NHC Cyclo Therapy Settings for my RLS NOTE this is guide please familiarise yourself with the product and use at the speeds and settings your are comfortable with and consider effective Application increase circulation reduce swelling heal a wound Product Speed NHC Cyclo Therapy Hand Unit Low to High NHC Cyclo Therapy CSTP pad 2 to 7 NHC Cyclo Therapy Bed 2 5 to 8 NHC Cyclo Therapy Chair 2 5 to 8 NHC Cyclo Therapy CVT Used by Professionals CVT products are used at specialist spinal injury centres across the country Occupational and physiotherapy use CVT to relax tight muscles soften tissues reducing swelling and pain management We use it daily for reducing high tone to get muscle relaxation Emma Lindley Clinical Lead Occupational Therapist London Spinal Cord Injury Centre 54 Staying Healthy at Home Staying Healthy at Home Chest clearance to help breathe easier There are numerous conditions wherein the airways become inflamed and the air sacs in the lungs are damaged This causes airflow obstruction resulting in narrower airways making it difficult to breathe in and out comfortably A number of chronic lung diseases which NHC Cyclo Therapy addresses are COPD Bronchiectasis Asthma Cystic Fibrosis Plus additional common problems such as infection from a cold or flu virus allergies or acid reflux can lead too Chest Congestion the accumulation of mucus in the lungs and lower breathing tubes bronchi It is usually accompanied by a wet productive cough that brings up thick mucus Chest congestion may cause you to hear or feel wheezing or crackling sounds when you breathe in and out Chest tightness this can be both medical and muscular in severe cases accompanied by dyspnoea often described as an intense tightening in the chest difficulty breathing or breathlessness RESEARCH Extracts Using NHC Cyclo Therapy to help chest clearance for ventilated patients in hospital A research study published by Chen YC in 2009 stated that almost 80 of patients in the intensive care unit are intubated and on mechanical ventilation Thus their ability to clear their chest and airways is compromised and their risk of lung collapse increased A number of interventions are used to enhance airway clearance with the goal of preventing atelectasis and infection The purpose of this study was to evaluate the effect of a chest vibration nursing intervention on the expectoration of airway secretions and in preventing lung collapse among ventilated critically ill patients 55

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METHODS A randomized single blind experimental study A total of 95 patients were enrolled from 2 intensive care units and randomly assigned into either the NHC Cyclo Therapy group 50 or control group receiving standard care 45 of routine positioning care which consisted of a change in body position every 2 hours Patients in the NHC Cyclo Therapy group received routine positioning care plus the use of a NHC Cyclo Therapy pad for 72 hours This consisted of placing the therapy pad on the patients back for 60 minutes when the patient was in a lying supine position NHC Cyclo Therapy was applied 6 times a day Outcome variables were cough dry sputum weight DSW per 24 hours and lung collapse index LCI these were measured at 24 48 and 72 hours RESULTS Patients who received the NHC Cyclo Therapy had greater DSW and lower LCI after 24 hours Pre test DSW and group could explain 48 2 of the variance in DSW at 24 hours The LCI at 24 48 and 72 hours were all significantly improved in the therapy group compared to the control group A significant difference was found between the control and experimental groups in their 24 48 and 72 hour DSW and LCI after NHC Cyclo Therapy IN CONCLUSION The results suggest that chest vibration with NHC Cyclo Therapy may contribute to expectoration and thus improve lung collapse among ventilated patients in an ICU Chest vibration nursing intervention is a safe and effective alternative pulmonary clearance method and can be used on patients who are on ventilators in ICUs Ref Chen YC et al Using chest vibration nursing intervention to improve expectoration of airway secretions and prevent lung collapse in ventilated ICU patients a randomized controlled trial J Chin Med Assoc 2009 Jun 72 6 316 22 In what circumstance will NHC Cyclo Therapy help chest clearance Applying NHC Cyclo Therapy to the back or chest may stimulate the smooth muscles of the trachea bronchial tubes These muscles are controlled by the automatic nervous system but we have seen how muscles respond favourably to NHC Cyclo Therapy usually within five to ten minutes without other modalities i e muscle relaxing drugs This can help release mucus to encourage effective coughing and improve chest clearance to improve breathing Breathlessness may be eased by the soothing and rhythmic muscle vibration to enable muscle relaxation and to help the general feeling of breathlessness anxiety Using NHC Cyclo Therapy to help chest relaxation A Study by Binks AP published in 2001 Stated that Vibration of the chest has been shown to modify the drive to breathe and the sensation of dyspnoea breathlessness It has been suggested that respiratory muscle afferents nerves within the muscle generate these effects The possibility that the consequences of chest wall vibration also involve intra pulmonary afferents led us to investigate whether such vibration reaches the airways Two vibratory stimulations were independently applied to four chest wall sites and two control sites on eight healthy subjects During separate breath holds the vibrator was held on each site while subjects periodically opened and closed the pharynx throat Airway pressure P AW was measured at the mouth Spectral analysis of P AW showed pressure oscillations occurred at the same frequency as that of the vibrators when the pharynx was open oscillation amplitude was vastly reduced when the pharynx was closed Oscillation amplitude was also significantly larger during vibration at greater amplitude These data demonstrate that vibration over the chest wall vibrates the lung and could potentially excite intrapulmonary receptors Ref Binks AP et al Oscillation of the lung by chest wall vibration Respir Physiol 2001 Jul 126 3 245 9 56 Staying Healthy at Home Effects of Vibrating pad on chest clearance The effect of vibration 41 0 5 4 Hz 2 mm amplitude on the clearance of lung secretions was ascertained in 10 patients with chronic bronchitis who complained of difficulty in raising sputum Vibration was applied to the back for one hour by an electrically driven pad while the patients reclined on a couch with the trunk at 45 degrees to the vertical Each patient had randomized control and experimental runs of 5 hours duration that were identical in all respects except for vibration The rate of clearance of secretions from the lung was assessed by serial whole lung counts after inhaling mono dispersed tracer particles tagged with a gamma emitting radioisotope technetium 99m and by sputum production The mean rates of clearance and of sputum production were slightly higher during the vibration runs than the control runs but the differences were not significant Ref Thomson ML Phillipakos D A preliminary study of the effect of a vibrating pad on bronchial clearance Am Rev Respir Dis 1976 Jan 113 1 92 6 Chest vibration nursing intervention is a safe and effective alternative pulmonary clearance method and can be used on patients who are on ventilators in ICUs A preliminary study of the effect of a vibrating pad on bronchial clearance Am Rev Respir Dis 1976 Jan 113 1 92 6 How to use NHC Cyclo Therapy for Chest Clearance Where to apply the NHC Cyclo Therapy Apply directly to the back or chest applying the CSTP pad to the back in a seated position or the Hand Unit to the Chest Using a NHC Cyclo Therapy bed or chair use the therapy in the back section What speed of therapy should I apply Test speed settings while speaking at the speed where your voice starts to oscillate can indicate that this is oscillating your airways and chest to help release mucus What speed of therapy should I apply to help chest relaxation and breathlessness Please refer to the section of this book called Muscle Relaxation similar speeds apply to help chest relaxation How long should I use the NHC Cyclo Therapy for For both chest clearance and relaxation we would stipulate around 20 to 30 minutes at a time initially potentially building up to 1 hour The main thing is to apply when most comfortable for you by testing various options Why is it making my cough more When releasing mucus this may cause some irritation that results in coughing more frequently coughing is required to remove the released mucus from the lungs How often should I use the NHC Cyclo Therapy per day On average people use the NHC CycloTherapy 2 to 3 times a day 57

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Staying Healthy at Home NHC Cyclo Therapy combined with the benefits of adjustable posture the ideal combination Combining NHC Cyclo Therapy in our adjustable furniture means you get the health benefits of both the therapy but also additional health care by the position you use the therapy Here are a few quick reasons why On average we spend a third of our lives in bed This is the same amount of time as standing or sitting and so our posture in bed is vitally important Investing in the right bed can help you to sleep better have better posture and enjoy a more comfortable night s rest Comfort support your whole body to reduce pressure points Lying flat generates a number of unsupported pressure points on the body These points relate to the areas of the body carrying the most weight and the bony prominences close to the skin such as the Hips Head Shoulders Heels Sacrum the triangular shaped bone at the bottom of the spine The ideal and most comfortable position therefore in principle is a zero gravity position to eliminate these pressure points The smooth accurate and contouring control of an Adjustamatic bed allows you to position and contour the bed to support and reduce tension of these pressure points Reducing pressure points can improve your general health by relieving the pressure of your joints and weight bearing areas This also improves skin and soft tissue blood flow to any areas subject to pressure Medical research based on 10 different lying positions with 62 healthy volunteers shows that using an adjustable bed to raise the legs and head of your bed slightly by 20 to 30 degrees generates a soft contour position that will reduce the amount of pressure between you and the mattress surface This soft contour position will support the body to take the strain off the spine and pivot point joints giving you as relaxed position as possible to zero gravity References Defloor T 2000 The effect of position and mattress on interface pressure Appl Nurs Res 13 2 11 Call E Baker L 2007 How does bed frame design influence tissue interface pressure A comparison of four different technologies designed for long term or home care Journal of Tissue Viability 17 22e29 58 Reducing back pain with adjustable posture and a Therapy bed or chair Sleeping in the wrong position can exacerbate back pain or cause back pain in those who don t typically have it Your spine is an S shaped curve So when you lie on your back you put pressure on the areas that are not supported such as the lower back where the arc is at its peak If you were to lie down on the floor flat on your back you should be able to put your hand under the arc of your spine This proves that it is not fully supported and in return causes the vertebrae to squeeze the discs in the back which can lead to severe back problems Back pain and problems can develop over time if the body is not in a natural position while you sleep An Adjustamatic bed is capable of closely matching the contours of the body and that reduces the pressure on the spine Some back pain sufferers will pile pillows up However that can lead to awkward positions for the neck leading to stiffness and muscle strains Adjustamatic beds however provide this elevated position without putting extra pressure on the neck Sleeping on your back puts approximately 50 pounds 20kg of pressure on your spine so raising your knees while lying on your back cuts pressure on your spine roughly by 50 Ref The American Chiropractic Association 2015 Smith M T Edwards R R McCann U D Haythornthwaite J A 2007 The effects of sleep deprivation on pain inhibition and spontaneous pain in women Sleep 30 494 505 59

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Reducing ankle and leg swelling with adjustable posture and a Therapy bed or chair Adjusting your sleep or sit posture with an NHC Cyclo Therapy bed or chair by raising the lower legs above the level of the heart by 3 to 6 inches will help to reduce lower leg ankle and feet swelling improve microcirculation and oxygen delivery In medical trials leg elevation acting against gravity increased blood flow within veins by 45 and reduced lower leg swelling With leg elevation you ll notice it feels good immediately It takes the pressure off your leg veins first and foremost encouraging the blood to flow out of your leg veins emptying them and undoes the pressure of the day by giving your veins a break for a few hours as blood flow moves away from the legs and courses through the rest of your body The raising of limbs and joints on an adjustable bed overnight can help the speeding up of the healing process It allows blood to flow more quickly which leads to the healing of bruises and reduction of swelling Reference Abu Own A Scurr J H Coleridge Smith P D 1994 Effect of leg elevation on the skin microcirculation in chronic venous insufficiency J Vasc Surg 20 705 710 Improve Breathing with adjustable posture and an NHC Cyclo Therapy bed or chair A range of medical conditions that can cause disturbed sleep are associated with breathing or respiratory problems in bed at night These include but are not limited to Snoring and sleep apnoea Chronic Obstructive Pulmonary Disease COPD Emphysema General chest congestion normal inflamed Applying the benefits of changing posture in bed has shown to improve respiratory breathing rates Using the head elevated position in patients in hospital on ventilation has shown that reducing the effects of gravity on the diaphragm with a raised head position improves breathing compared to the patient lying on their side Reference Shah D S Desai A R Gohil N 2013 A comparison of effect of semi Fowler s vs side lying position on tidal volume pulse oximetry in ICU patients Innovative Journal of Medical and Health Science 2 How can improved posture in bed help relieve the symptoms of snoring and sleep apnoea in conjunction with other treatments The worst position for snoring and sleep apnoea is lying flat on your back as the tongue falls back more readily against the pharyngeal wall due to gravity Harper and Sauerland 1975 25 identified that changing position of the head can prevent this Lifting the head up and sleeping at a slight incline can change the effect that gravity has on the neck drastically reducing snoring and the instances of sleep apnoea Medical research has shown that sleeping in a more upright position like this improves the 60 Staying Healthy at Home airflow in the airways which thus improves oxygen in the blood One study demonstrated that for approximately half of people studied obstructive sleep apnoea was essentially abolished by the postural intervention and arousal from sleep was less frequent in a more upright posture Ref McEvoy R D Sharp D J Thornton A T 1986 The effects of posture on obstructive sleep apnoea Am Rev Respir Dis Apr 133 4 662 6 Lying on your side with your head raised will also help reduce airways collapsing and improve airflow and breathing for individuals with snoring and sleep apnoea problems Ref Ravesloot M J L van Maanen J P Dun L de Vries N 2013 The undervalued potential of positional therapy in position dependent snoring and obstructive sleep apnea a review of the literature Sleep Breath 17 39 49 Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease COPD is the name for a collection of lung diseases including chronic bronchitis emphysema and chronic obstructive airways disease COPD is one of the most common respiratory diseases in the UK It usually starts to affect people over the age of 35 although most are not diagnosed until they are in their 50s It is thought there are over 3 million people living with the disease in the UK of which only about 900 000 have been diagnosed Symptoms of COPD include breathlessness a persistent cough with poor chest clearance and frequent chest infections Due to breathlessness and gravity on the chest and diaphragm sleeping in a flat position can exacerbate breathlessness so using an Adjustamatic bed for appropriate posture positioning may help relieve the symptoms of COPD For example elevating the head of the bed by 45 degrees allows the diaphragm to expand to improve respiratory function and reduce pulmonary venous congestion One clinical study based on 38 stable COPD patients supports that head elevation particularly the semi fowler position in bed improves breathing Reference Ichiba T Miyagawa T Kera T Tsuda T Kokubu F 2011 Late breaking abstract Efficacy of relaxation posture in patients with chronic obstructive pulmonary disease COPD Eur Respir J 38 p3641 61

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Improve digestion with adjustable posture and a Therapy bed or chair Using your Adjustamatic bed to improve posture will help with digestion at night and while sleeping Many studies have tied eating before sleep to weight gain digestion which can be helped by allowing gravity to work normally If a person is lying completely flat the effects of gravity are seriously impeding digestion However sleeping at an incline can help the body to better digest food that is still in the stomach If your head is elevated your stomach will be below your oesophagus so acid or food will stay in your digestive system Reduce heart burn acid reflux with an Adjustamatic bed A common problem for many people at night is acid reflux affecting up to 40 of the population This involves stomach acid travelling up through the oesophagus and causing a painful burning sensation In some instances prolonged reflux can generate healthcare concerns On a flat bed acid moves to the oesophagus leading to episodes of acid reflex or heartburn Applying an inclined position offered by an Adjustamatic bed allows gravity to work against acid reflux helping the stomach to retain the acids improving the chances of a full night s sleep Medical research has shown that applying an inclined position at night will reduce acid reflux In one of many clinical trials a study with 24 reflux sufferers lying flat on a bed was compared to lying in the head inclined position The study showed that bed head elevation reduced oesophageal acid exposure and acid clearance time acid reflux in nocturnal refluxes and led to relief from heartburn and sleep disturbance References Khan B A Sodhi J S Zargar S A et al 2012 Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux J Gastroenterol Hepatol Jun 27 6 1078 82 Johnson L F DeMeester T R 1981 Evaluation of elevation of the head of the bed bethanechol and antacid form tablets on gastroesophageal reflux Dig Dis Sci Aug 26 8 673 80 Datta K Rahalkar K Dubey D K 2011 Prasad BA The effect of posture on esophageal pH in endoscopy normal reflux disease ENRD cases Indian J Physiol Pharmacol Oct Dec 55 4 315 21 62 Staying Healthy at Home CONTRAINDICATIONS There are certain conditions in which our NHC Cyclo Therapy should not be used with Please take note of the following such conditions listed below Active Deep vein thrombosis Pulmonary embolism Active thrombophlebitis Osteomyelitis Severe Osteoporosis Active cancer Pregnancy Uncontrolled epilepsy Severe wound infection not receiving antibiotic therapy for Active Aneurism Severe tissue necrosis Charcot s foot DEFINITIONS Active relates to a specified condition or diagnosis that you are aware of having or suffering from at the time of using the therapy Active cancer is defined as a cancer diagnoses or are in remission at the time of using the therapy Severe Osteoporosis is defined as a health condition that weakens bones making them fragile and more likely to break fracture Symptoms can include a fracture from a fall or even from a strong sneeze or cough back neck pain or loss of height CAUTIONARY Although we do not have any evidence of an adverse reaction we recommend that you consult with your doctor with regards to using the NHC Cyclo Therapy in the following areas of the body or in any of the circumstances listed below If you have a pacemaker fitted we do not advise usage of the therapy against the chest or upper back area as a precaution The therapy is able to be used against the lower back and upper and lower legs If you have an active infection and you are not receiving antibiotic treatment If you have active unstable bone structures or fragments Over an area of a recent joint replacement as a temporary precaution recent is defined as within six weeks DISCLAIMER Important The content in this document is provided as a general guidance on the conditions described and is not intended to be acted upon or substituted for medical advice or from seeking medical advice from your GP or other healthcare professional In the event of a diagnosis or a coincidental diagnosis received relating to any of the above mentioned conditions Niagara Healthcare Limited and its associated companies is not responsible or liable for any such diagnosis that may arise out of any potential misuse of their products NHC Cyclo Therapy or misinterpretation of the information which is provided as general guidance only You should always consult with your GP in the first instance with regards to any health concerns The Company may from time to time amend modify or update this guidance and or issue supplemental guidance to coincide with any advancements to our design and technology specifications in accordance with our continued research and development programme 63

NHC Cyclo-Therapy. Staying Healthy at Home

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