Chattanooga’s Cefar® transcutaneous electrical nerve stimulation (TENS) is our next generation of handheld TENS device, building on the established technology of the Primo Pro with added features to combine TENS, neuromuscular electrical stimulation (NMES) and electro-acupuncture (EA) treatments in one portable unit.
Intended for use by both healthcare professionals and patients, the Cefar® TENS combines TENS with NMES to bring pain relief and muscle rehabilitation from the clinic to the home. Patients can begin treatment with the device in a clinical environment under the supervision of a healthcare professional, before continuing their rehabilitation in the comfort of their own home. Simple and easy to use, with a range of compliance features, patients can be confident about taking their treatment into their own hands while their clinician can easily set parameters and monitor their progress.
For healthcare professionals this equals faster recovery times and shorter stays for patients, less pressure on resources, and less use of analgesics, therefore patients can benefit from reduced pain, increased mobility, and greater independence.
Altogether, Cefar® TENS is more than just a pain machine.
- Symptomatic relief and management of chronic, intractable pain.
- Adjunctive treatment for post-surgical and post-trauma acute pain.
- Relief of pain associated with arthritis.
- Retarding or preventing disuse atrophy.
- Maintaining or increasing range of motion.
- Re-educating muscles.
- Increasing local blood circulation.
Features and Benefits
1+1 Function: The Cefar® TENS stimulator features 2 independent channels that can be managed separately. Users can select either the same program on both channels, or 2 different programs to be used simultaneously, allowing a combination of NMES and TENS in one treatment. This means patients can rehabilitate the affected area while reducing the associated pain, resulting in a more comfortable and effective treatment.
The device has 10 preset program modes and can allow users to create up to 5 custom programs. This gives clinicians the ability to prescribe an initial treatment regime that patients can be confident in using, while still allowing room for future modification.
The Cefar® TENS unit uses standard electrodes with pin and socket connection. Any size electrodes having this feature can be used with this unit.
Clinicians can easily keep track of patients’ home treatments by monitoring how many hours of usage since the device was reset, along with total device usage. The device also features a locking function to ensure the patient will only use the appropriate program.
When connected to acupuncture needles, Cefar® TENS can be used to deliver electro-acupuncture treatment. As electro-acupuncture has been shown to be particularly effective in the reduction of pain, this provides a further, more beneficial option for patients to reduce their discomfort.
*Clinician use only. Acupuncture needles not supplied.
Rotatable belt clip
When connected to the belt clip, the device can be rotated to allow convenient access to the cable outputs.
- Gatewood CT, et al., The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):501-516.
- Rakel B, Frantz R, Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement. The Journal of Pain, Vol 4, No 8 (October), 2003: pp 455-464
- Johnson MI, Jones G, Transcutaneous electrical nerve stimulation: current status of evidence. Painmanag (2017)7(1)
- Johnson MI, et al., Transcutaneous electrical nerve stimulation for acute pain. Cochrane database of systematic reviews 2015 issue 6
- Sbruzzi G, et al., Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of 11 randomized trials. Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):75-87.
- Osiri M, et al., Transcutaneous electrical nerve stimulation for knee osteoarthritis. The Cochrane Library 2008, Issue 2
- Bjordal JM, et al., Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials. BMC Musculoskeletal Disorders 2007, 8:51
- Gould N, Donnermeyer D et .al., Transcutaneous Muscle Stimulation as a Method to Retard Disuse. Clin Orthop Rel Res, 178:190–197, 1983
- Labanca L, et al., Neuromuscular Electrical Stimulation Superimposed on Movement Early after ACL Surgery. Med Sci Sports Exerc. 2018 Mar;50(3):407-416.
- Topp R, et al., The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty. Physical Medicine and Rehabilitation, Volume 1, pp. 729-735
- Broderick BJ, et al., Haemodynamic performance of neuromuscular electrical stimulation (NMES) during recovery from total hip arthroplasty. J Orthop Surg Res. 2013 Mar 5;8(1):3.
- Sangdee C, et al., Electroacupuncture versus Diclofenac in symptomatic treatment of Osteoarthritis of the knee: a randomized controlled trial. BMC Complementary and Alternative Medicine 2002, 2:3
Program Description and Recommendations
Conventional TENS (high-frequency stimulation) is a good choice for both acute and long-term pain, both neurogenic and nociceptive. Conventional TENS is based on the Gate Control theory, which states that electric stimulation of A-beta fibers inhibits impulse transfer in the pain pathways. As a rule, the electrodes should be placed on or near the painful area, or over an area segmentally related to the painful area. Adjust the amplitude so that the stimulation gives strong, but pleasant paraesthesia – tingling. When using high-frequency stimulation, it’s important to ensure that the patient has normal sensory of touch in the area where the electrodes are placed.
Burst TENS (low-frequency stimulation) is usually most effective for radiating (projected) pain in the arms and legs (rhizopathy), for conditions with reduced or changed sensory of touch, for deep muscular pain, or when the post-treatment effect of conventional TENS is too short. Burst TENS treatment alleviates pain by stimulating muscles to release the body’s own morphine-like substances, endorphins. Place the electrodes on a muscle in the painful area so that a visible contraction occurs, or on acupuncture points in the painful area. The stimulation should feel pleasant and give visible muscle contractions. Remember that the patient often feels the stimulation clearly before contractions become visible.
Modulated pulse duration stimulation is a type of high-frequency stimulation where the pulse duration varies continuously. This can cause an undulating sensation, which may be more pleasant than a constant pulse duration. Use Program 3 for pain alleviation and a massage effect on muscles like the trapezius.
Program 4 has a shorter pulse duration than the other programs. A short pulse duration is suitable for treating sensitive, nerve-rich areas like the face and high up on the neck. With a shorter pulse duration the amplitude can be increased, which makes it easier to find the right level without the patient experiencing pain.
Mixed frequency stimulation is also called Han stimulation (3 sec at 2 Hz and 3 sec at 80 Hz). Stimulation frequencies switch every three seconds, giving a combination of high- and low-frequency stimulation, which can offer a more effective treatment. Place the electrodes as you would for low-frequency stimulation – on a muscle in the painful area.
Program 6 is specifically designed for treating acupuncture points on a neurmodulation mode. For nausea, place the black electrode on acupuncture point PC6 (inside of the wrist) and the red one on acupuncture point TE5 (outside of the wrist). For pudendale pain as for incontinence treatment, place the electrode on SPE nerve on medial part of the ankle.
Always use 2 channels and 4 electrodes with Program 7. A modulated pulse duration stimulation is obtained, but since the channels are alternately active, a massaging, pumping effect is experienced. Place the electrodes as for high-frequency stimulation when a pain relieving and massaging effect is desired.
An increase in the tension of the contractured muscle fibres and the crushing of the capillary network resulting from this causes a decrease in the blood flow and a gradual accumulation of acid metabolites and free radicals. Without treatment, there is a risk that the contracture will become chronic and genuine atrophy of the capillary network may gradually occur. In addition to the general effect of increasing endorphin production in the hypothalamus, which elevates the pain perception threshold, there is a very significant localised effect. The 5 muscle twitches induced every second by stimulation produce very significant hyperaemia (increased blood flow to the area), which drains the acid metabolites and free radicals that had accumulated in the chronically contractured muscle areas.
The principle is to cause a significant influx of tactile sensitivity in order to restrict the entry of pain impulses upon their return to the posterior horn of the spinal cord. We must therefore stimulate the sensitivity fibres on the skin of the painful area. To do this, it is necessary to use a frequency that is the same as the operational frequencies for the tactile sensitivity nerve fibres that could attend 100 Hz
A muscle that is normally innervated, after a period of immobilisation or diminished movement due to pain or restricted range of motion, rapidly decreases in volume. This decrease depends on the degree and duration of the functional deficit. Slow fibres (type I) in particular are affected by disuse atrophy.
In the Programming mode you could create a custom program and select your own parameters.
Select These Options For an Even Better Experience
There are several options to choose from:
- Electrotherapy Pads - Select additional pads to use with your device. Generally choose larger pads for larger areas or if you want a more comfortable experience. The smaller the pads, the more energy moves through a smaller space and this can be more sensitive to some individuals.
- Pre-TENS Skin Prep Wipes - It is recommended to use the wipes before placing the pads on your skin. It will give a much better connection and improve the ability of the device to help reduce your pain and increase the rate of recovery. These wipes will also help prolong the life of the electrode pads.
- Physiotherapy Consult - Not sure exactly how to use your device? Want to understand the different settings and how it will best help you? Want to ask a physiotherapist where the pads should be placed for the best result? Choose this option to talk with a registered physiotherapist. Once you get your device, we will setup a time to talk with one of our physiotherapists. We will send a separate invoice with the therapists billing number so you can submit this to your insurance company for reimbursement.
Chattanooga Cefar Devices Warranty – LIMITED 3 YEARS
If there are any issues within the first 30 days of purchasing the device, you can return it to us, The Physio Store Inc. and we will replace the device free of charge.
After this time, the remaining Warranty will be honoured by the manufacturer - Chattanooga.
You can register your warranty with them directly at Chattanooga Warranty Registration Page.
Register before the warranty period runs out. You will receive an email confirming your warranty registration.
We offer free advice from a registered treating Physiotherapist.
Similarly to having a pharmacist available to answer your questions in regards to medications you buy at a pharmacy, we are here to answer your questions on our products in regards to your health.
We can discuss general issues about injuries, muscles, joints, pain etc. and provide advice on what products and exercises will help your specific needs. We will respond within 24 hours.