DynX turn-on is activated by pressing the SELECT pushbutton, observing the LCD display sequence ending in GRIP TEST. Press and hold SELECT for 2 seconds to turn-OFF DynX (or wait 5 minutes - without use DynX will automatically turn-OFF).

DynX performs a self-diagnostic accuracy test during the turn-ON sequence and will block further use if the DynX digital calibration has shifted. Should this occur, restart the DynX and make sure it is not being held by the handle. Any minor force being applied to the DynX handle could trigger a false calibration test error. Press and hold SELECT for 2 seconds to turn-OFF DynX (or wait 5 minutes - without use DynX will automatically turn-OFF).

Confirguring DynX in Metric or English units of measure, select Audible Tones ON-OFF, and Data Archive-Erase may be selected. After DynX turn-ON, press the MENU key until CONFIGURATION mode is displayed, then press SELECT to SET UNITS, then press MENU to change the display from LB to KG or from KG to LB - then press SELECT.

The audible tone (beep) may be turned ON or OFF in CONFIGURATION MODE after pressing SELECTing UNITS. the display will move to the SET TONE: /TONE Y (yes) or press MENU key to change TONE:Y to TONE:N (no) The TONE:Y means the tone will occur each time a Menu or slect key is pressed, or when some action is to be taken by the user.

Each time the DynX is turned ON it stores the date/time and any further actions taken by the user in the DynX non-volatile memory. To ERASE the stored data, change the CONFIGURATION ARCHIVE: ERASE N to ARCHIVE: ERASE Y by pressing the SELECT key.

MAX test, ENDURANCE test, and RAPID EXCHANGE test

After TEST MODE is on the display, press SELECT to see MAX TEST...press MENU to see ENDURANCE TEST ... press MENU again to see RAPID EXCHANGE ... press MENU again to display PREVIOUS MENU ... press MENU again to return to MAX TEST.

When MAX TEST is displayed, press SELECT to perform MAX TEST measurements, MAX TESTS measure the maximum strength of the muscle group applying force to the DynX handle. Up to 10 MAX measurements may be collected.

Blind test may be measured by having the user point the DynX display away from their vision, most likely towards a clinician. Users may observe their own measurements by turning the display towards themselves.

Each MAX effort collects the maximum force applied to the DynX handle in Pounds or Kilograms, the date and time of that measurement. Since up to 10 MAX efforts may be measure for a client, the DynX collects each measurement, then calculates and collects Average, Standard Deviation and Coefficient of Variation related to the series of MAX measurements. Following each MAX measurement the clinician is required to validate the measurement by pressing the SELECT key to store the data in memory.

Press SELECT to measure MAX 2 ... then press SELECT to store that data and note the numbers AVG, SD and CV have calculated the new Statistics. Continue MAX 3, 4, 5 etc up to 10 MAX measurements. Press the SELECT key repetitively anytime during the test to review all data, or press the MENU key to provide options to RESTART MAX TEST, REVIEW LAST DATA, or PREVIOUS MENU.

After pressing the SELECT button to accept the measurement, the display changes to show Statistics of Average (AVG 1) and the measurement along with SD (Standard Deviation) and CV (Coefficient of Variation). Since there is only one measurement SD and CV are zero. Press SELECT to measure MAX 2….then press SELECT to store that data and note the numbers in AVG, SD and CV have calculated the new Statistics. Continue MAX 3, 4, 5, etc. up to 10 MAX measurements. Pressing MENU at any time to review the sequence of MAX measurements. MENU also provides options to RESTART MAX TEST, REVIEW LAST DATA, or return to PREVIOUS MENU.

Strength and Endurance are two totally different, but interrelated quantities. DynX provides a means of collecting endurance data for a User based on a selected Target Force and track how strength decays over time while the User attempts to exert maximal effort at or below the Target Force.

Taget Forces are a percentage of MAX Strength. Target Force is typically set at 50% MVC but is whatever the Clinician determines appropriate for each User. Endurance tests how long a User is able to sustain the specified Target Force on the DynX handle. DynX collects time at or above Target Force and at or above 90%, 80%, 70%, 60%, etc of Target Force, retaining these in memory for later review and plotting the User’s endurance profile.

When the Endurance Test is completed, the display shows Max Force, Target Force, 100% Score, and time in seconds the User maintained a force of 100% Target. Press SELECT to show time duration during which the User maintained a force of 90% of Target Force or higher. Press SELECT again to show time duration during which the User maintained a force of 80% or higher and continue pressing SELECT to review time duration to maintain Scores of 70%, 60%, 50%, etc or higher during the test. This data is stored in non-volatile memory for later review.

When the Endurance Test is completed, the display shows Max Force, Target Force, 100% Score, and time in seconds the User maintained a force of 100% Target. Press SELECT to show time duration during which the User maintained a force of 90% of Target Force or higher. Press SELECT again to show time duration during which the User maintained a force of 80% or higher and continue pressing SELECT to review time duration to maintain Scores of 70%, 60%, 50%, etc or higher during the test. This data is stored in non-volatile memory for later review

This test measures MAX strength alternately in each hand after a very short time delay. The clinician typically holds the DynX while looking at the display to record each Right and Left hand strength measurement. Exchange rates are rapid enough to make it impossible for the User to fake a disability in one of the hands.

Holding the DynX for the User, have them SQUEEZE the DynX handle with their Right hand to start the Exchange clock which causes the DynX to emit an audible tone each time the handle is to be Squeezed in the next hand.

DynX selectable exchange rates are 0.8 seconds or 1.5 seconds during 10 or 20 exchanges. Because DynX accurately measures each right/left effort and stores it in memory, the Clinician avoids uncertainty in noting the force readings at each exchange and recording the data accurately.

When the Exchange measurements are completed the DynX display shows Average of 10 (A10) or 20 exchanges (A20), the Average number of seconds per exchange, Standard Deviation (SD) and Coefficient of Variation (CV) of all measurements. Pressing the SELECT key causes the display to show the first Right Hand Max and the Average of all measurements…then pressing SELECT again displays the second measurement in the Left Hand. Pressing SELECT sequentially shows all individual measurements.

Grip Extenders are provided to lengthen the Grip Width by ½ inch increments which are industry standards. One Grip Extender may be attached to the rear handle and another to the Front handle.

To install a Grip Extender to the DynX handle, simply slide the Grip Extender upward until the latch at the top of the Grip Extender “clicks” into the handle slot. To remove a Grip Extender from the DynX handle, place the bottom of the Grip Extender into the palm of your hand, then press downward on the latch with your first finger to depress the latch inward disengaging the Grip Extender from the handle. Slide the Grip Extender downward and remove it from the handle. Your thumb and second finger may be helpful to pinch the Grip Extender during this process.

DynX grip width without extenders is position 2, that has been used to establish grip strength norms. Adding one Grip Extender expands the width to position 3. Adding the second Grip Extender expands the width to position 4. Grip Extenders are recommended for use to provide a comfortable size width for each User, especially during Endurance Test and Grip Exercises. User comfort is one guide to the proper Grip Width to use during an Exercise. Another technique is to have the user hold the DynX in their hand and observe how much overlap, if any, occurs between the thumb and first finger as the DynX is grasped. An optimal Width is one where the thumb and first finger touch without any overlap.

Battery installation requires removing the Battery Door, locating the Battery Connector, placing the 9-volt battery next to the connector to match positive and negative battery posts with the appropriate connector sockets, then applying pressure to the top of the connector to snap the posts into the sockets. Once attached, the battery, wire leads and connector assembly is carefully slid into the DynX battery cavity. Once installed, the battery door is snapped into place. Replacing the battery requires removing the snap-on connector from the top of the battery. This is best accomplished by using a small slotted screw driver or table knife to carefully lever the snap-on metal connector sockets off of the metal battery terminals. Be careful to not damage the connector plastic cover and wires during this process. Pulling on the connector cover and wires will destroy the connector. Discard the discharged battery in an appropriate manner.

Batteries typically last 6 months or more depending upon DynX use. The DynX display will alert you with a REPLACE BATTERY notification at turn-ON when the battery voltage is low. Another indication of a failed battery is a dim display.

Batteries typically last 6 months or more depending upon DynX use. The DynX display will alert you with a REPLACE BATTERY notification at turn-ON when the battery voltage is low. Another indication of a failed battery is a dim display.

Controlled, timed isometric efforts spaced by timed rest period provide a scientific approach to muscle strengthening based on a Maximum Voluntary Contraction (MVC) strength measurement. Two protocols are provided in the form of Fixed and Stepped Regimens. Both regimens establish the amount of effort during the exercise as a percentage of MVC. Fixed Exercise uses the same Target Force effort in each repetition, Stepped Exercise begins with a low level Target Force effort and steps up to higher levels of Target Force efforts in each Rep. Each Target Force effort is timed. Lower levels of effort in either Fixed or Stepped Exercise are longer duration (greater than 1 minute) whereas higher levels of Target Force efforts are shorter (less than 1 minute). During any sustained isometric effort, such as weight lifting, the stressed muscles trap or impede blood flow during the effort, causing increases in systolic and diastolic blood pressure. Prolonged isometric efforts can quickly elevate systemic blood pressure. To control this risk, sustained efforts have limited duration and are spaced by rest periods.

DynX exercise protocols establish the level of effort, the time duration of the effort, the length of rest periods between efforts, and number of repetitions in a manner which achieves positive outcomes while average blood pressure levels remain normal. This is what we mean by Controlled Isometric Exercise regimens.

FIXED Exercise regimens typically do not exceed 50%MVC effort and 45 second durations spaced by rest periods of 1 minute or less, and 4 repetitions done 3 days per week. STEPPED Exercise begins with Step 1 at 20%MVC and increases Target Force levels by 20% for each new Step, ending with Step 5 at 100%MVC. Each Step is accompanied by appropriately timed effort durations and rest periods for each %MVC. Choice of using Fixed or Stepped exercise protocols is a matter of Clinician/User preference. STEPPED Exercise set-ups are simple…choose 1, 2, 3, 4, or 5 Steps and # of Reps. FIXED Exercise requires Clinicians to select %MVC, #Reps, Effort and Rest times. Significant Strength & Endurance results are achieved in 45 days. Increases of 15% hand-arm muscle group strength and 120% endurance have been documented in a 6-week period using the DynX exercises 3 times per week. Performing DynX exercises requires handgrip-eye coordination which elicits muscle control by reference to the Target Force shown on the LCD display. Transfer of visual images through optical and neural systems back to the working muscles adjusts forces on the DynX handle to maintain the required Target Force. Stimulation of this feedback system and repetitive practice weekly over a period of 45 days or more improves muscle controls which is beneficial to the User. Components of this physiological stimulation have been proven in research to modify and increase nitric oxide and its synthesis in the cardiovascular system leading to systemic vasodilatation, thereby improving cardiovascular health. Using DynX exercises also strengthens the upper arm and upper body muscle groups in addition to the hand-grip muscles.

An exercise SCORE provides Users feedback on how well they are complying with the exercise protocol. SCORE is a mathematical average of the force being applied to the device compared to the Target Force over time. As the exercise is in process the SCORE is an instantaneous calculation. 100% Score means the User is doing exactly what is required. A 107% Score is 7% higher than that required. An 84% Score indicates the User is doing only 84% of the effort required during the exercise. Rest Periods post a SCORE averaging all Scores up to the point of that Rest Period. The Final SCORE at the end of the exercise shows the User the overall SCORE for the entire exercise session.

A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. Contra-Indications & Cautions are heart or circulatory conditions which would prohibit the use of any cardio exercise training equipment. Heart valve issues, aneurisms, irregular heart rhythm problems are examples. Arthritis, carpel tunnel, pain from skeletal damage or tendonitis are reasons to avoid use of these or other similar hand-arm exercise regimens without a physician’s authorization.

Performing DynX exercises requires handgrip-eye coordination which elicits muscle control by reference to the Target Force shown on the LCD display. Transfer of visual images through optical and neural systems back to the working muscles adjusts forces on the DynX handle to maintain the required Target Force. Stimulation of this feedback system and repetitive practice weekly over a period of 45 days or more improves muscle controls which is beneficial to the User. Components of this physiological stimulation have been proven in research to modify and increase nitric oxide and its synthesis in the cardiovascular system leading to systemic vasodilatation, thereby improving cardiovascular health. Using DynX exercises also strengthens the upper arm and upper body muscle groups in addition to the hand-grip muscles.

Significant Strength & Endurance results are achieved in 45 days. Increases of 15% hand-arm muscle group strength and 120% endurance have been documented in a 6-week period using the DynX exercises 3 times per week.

DynX FIXED and STEPPED exercise protocols may be LOCKED so a User can only access the specific protocol set up by a Clinician. LOCKING an exercise protocol provides immediate access to the FIXED or STEPPED exercise and eliminates the use of any other DynX function or changes to the protocol until it is UNLOCKED

User comfort is one guide to the proper Grip Width to use during an Exercise. Another technique is to have the user hold the DynX in their hand and observe how much overlap, if any, occurs between the thumb and first finger as the DynX is grasped. An optimal Width is one where the thumb and first finger touch without any overlap. DynX grip width can be adjusted by adding or removing Grip Extenders to the rear and front handles. Grip Width #2 is the width of the handle without any added GRIP EXTENDER Add one GRIP EXTENDER to the rear handle by sliding the EXTENDER over the handle until it latches at the top and bottom to increase the grip width by ½ inch for Grip Width #3. Attach a GRIP EXTENDER to the front handle to expand to Grip Width #4.

After the DynX handle width is properly fit to the User’s hand to maximize comfort during the exercise and the Fixed Exercise has been selected, have the User sit upright in a chair next to a table where the DynX is held by the User in the hand to be exercised with the forearm positioned comfortably on the table and the DynX held vertically so the User can view the display in adequate reflected light. The display indicates “DO MAX…Squeeze Hard”. The User is encouraged to quickly (2 seconds) apply maximum force to the handle and then release the pressure. Press the SELECT key to enter a valid MAX measurement. The display nominates 50% MAX as a Target Force, or by sequentially pressing the MENU key the 50% MAX can be set to any Target Force level from 10% MAX to 100% MAX. Press SELECT when the preferred %MAX is displayed. The display now blinks on the number of REPs to be performed. It may nominate 4 REPS or by pressing the MENU key sequentially this #REPS can be changed from 1 to 10. Press SELECT when the preferred number of REPS is displayed. The display now blinks on the number of seconds HOLD which can be changed from 3 seconds to 120 seconds. In a similar manner, set the number of seconds for the REST time between efforts. Press SELECT when the protocol is acceptable.

Date and time the exercise was initiated; exercise paameters MAX, %MAX, #REPS, Effort and Rest times, final Score; #Reps completed. An exercise SCORE provides Users feedback on how well they are complying with the exercise protocol. SCORE is a mathematical average of the force being applied to the device compared to the Target Force over time. As the exercise is in process the SCORE is an instantaneous calculation. 100% Score means the User is doing exactly what is required. A 107% Score is 7% higher than that required. An 84% Score indicates the User is doing only 84% of the effort required during the exercise. Rest Periods post a SCORE averaging all Scores up to the point of that Rest Period. The Final SCORE at the end of the exercise shows the User the overall SCORE for the entire exercise session.

Performing a Fixed Exercise protocol is optimally done in a comfortable sitting or standing position while not moving and in an environment where the DynX display can be easily viewed. The exercise begins by holding the DynX in the hand to be exercised after properly dimensioning the grip width such that the hand can comfortably apply a sustained force to the handle at Target Force levels. Quickly apply a force to the DynX handle which equals or slightly exceeds the Target Force level. This causes the timer to begin counting down during the 1st REP period. Note the SCORE at Target Force level is 100%. It is important to maintain a SCORE of 100% but not to exceed 120% of Target during the EFFORT. When the timer counts down to zero you will note an audible “beep” tone to stop the EFFORT and relax your hand by opening and closing the hand. Monitor the REST TIME as it counts down to zero seconds. Perform the next REP in the same manner along with all REST periods. Note your Average SCORE for each REP and total SCORE at the end last REP.

Establishing a STEPPED EXERCISE protocol is very straight-forward. Do a MAX effort and SELECT that effort as being valid, choose the number of STEPS (1,2,3,4,5) and the number of REPS to be performed (1 to 10).

Date and time the exercise was performed; the exercise protocol parameters MAX, #Steps, #Reps; and final SCORE achieved during the exercise session.

Performing a Stepped Exercise protocol is optimally done in a comfortable sitting or standing position while not moving and in an environment where the DynX display can be easily viewed. The exercise begins by holding the DynX in the hand to be exercised after properly dimensioning the grip width such that the hand can comfortably apply a sustained force to the handle at Target Force levels. Quickly apply a force to the DynX handle which equals or slightly exceeds the Target Force level. This causes the timer to begin counting down during the 1st Step of the 1st REP period. Note the SCORE at Target Force level is 100%. It is important to maintain a SCORE of 100% but not to exceed 120% of Target during the EFFORT. Note the SCORE of the 1st Step/1stRep during the Rest Period.When the timer counts down to zero you will note an audible “beep” tone to stop the EFFORT and relax your hand by opening and closing the hand. Monitor the REST TIME as it counts down to zero seconds. Perform the next STEP/REP in the same manner along with all REST periods. Note your Average SCORE for each REP and total SCORE at the end last REP. You will note that the 1st Step of each REP is the highest Effort Step, followed by sequentially lower Effort levels in succeeding Steps until each REP is completed.

DynX calibration is totally automatic and traceable to U.S. National and International Bureau of Standards calibrated weights. Calibration of each DynX is done across its full operational range of 0.0 pounds through 200.0 pounds in 10 pound increments. Accuracy at all of these data points is collected and published in a Certificate of Calibration provided with each DynX. A sophisticated electric linear actuator applies a force to the handle at 3 points, top-bottom-center, to confirm accuracy under all three load positions. A Certificate of Calibration is provided with each DynX serial number to document the exact profile of variance across that specific device’s operational range.

DynX accuracy and reliability to have repeatable accuracy are important design objectives built into every DynX. Components of this device include its two strain gauge sensors mounted on a high density laminate non-corrosive substrate material which has dimensional stability over a wide temperature range. The two electronic strain gauges are attached to the substrate in a manner which preloads each strain gauge following assembly so they are under tension when no force is being applied to the DynX handles. This pre-load is an important factor enabling a calibration self-test at time of device Turn-ON. This is called a zero-point test which, if it changes, indicates the device has changed its inherent accuracy across its operational range. This zero-point preload value is compared with what it was when the device was calibrated. When a change in zero-point preload is detected, the DynX device fails the Turn-On test and displays an ERROR Code on the display thereby stopping the device from being used for Test or Exercise. Unlike hydraulic and hydraulic Digital devices which are temperature sensitive, heavy and prone to physical abuse damage, leakage and the need for yearly confirmation of accuracy by returning the devices to a repair station, the DynX electronic design and its built-in self-test with automatic ERROR alert confirms total reliability and repeatable accuracy over many years of use.

A Certificate of Calibration is provided with each DynX serial number to document the exact profile of variance across that specific device’s operational range.

DynX accuracy and reliability to have repeatable accuracy are important design objectives built into every DynX. The cut-away illustration shows DynX components of this device, noting the sophistication of this design. Its two force sensors are mounted on a high density laminate non-corrosive substrate material which has dimensional stability over a wide temperature range. The two electronic strain gauges are attached to the substrate in a manner which preloads each strain gauge following assembly so they are under tension when no force is being applied to the DynX handles. This pre-load is an important factor enabling a calibration self-test at time of device Turn-ON. This is called a zero-point test which, if it changes, indicates the device has changed its inherent accuracy across its operational range. This zero-point preload value is compared with what it was when the device was calibrated. When a change in zero-point preload is detected, the DynX device fails the Turn-On test and displays an ERROR Code on the display thereby stopping the device from being used for Test or Exercise. DynX calibration is totally automatic and traceable to U.S. National and International Bureau of Standards calibrated weights.

DynX is designed to archive data each time it is turned-ON to enable how the device was utilized following turn-On and collect data pertaining to that use for later evaluation and record-keeping in either a clinical or research setting. Each time the DynX is turned ON it date and time-stamps a file in the device’s non-volatile electronic memory and stores any modality of use with data collected relative to that mode and use, all stored by date and time. This data archive may be erased by a clinician within the Configuration Mode.

Archived Data may be transferred to a PC using a specially designed cable connected to the DynX Data Port and the PC USB COM Port. The PC must be configured with DynX PC Application software available at no charge for DynX customers on the MD Systems website by registering the DynX serial number and owner’s registration information. Another use of the PC Interface cable and application software is to Remote Monitor DynX use which allows a Clinician to have a Client perform Grip Exercises themselves while Clinicians attend to other tasks and have the Client’s use of Grip Exercise or Test to be displayed on a PC screen at another location within the clinic.

Another use of the PC Interface cable and application software is to Remote Monitor DynX use which allows a Clinician to have a Client perform Grip Exercises themselves while Clinicians attend to other tasks and have the Client’s use of Grip Exercise or Test to be displayed on a PC screen at another location within the clinic. Clinicians find PC Interface and Data Archive downloads also helpful to document patient use of DynX Exercise protocols at home when DynX devices are consigned to patients for home use. Clinicians can then evaluate patient compliance with the prescribed exercise regimen to determine when they performed the protocol and how compliant the patient was by reference to dates-times and Scores achieved during home use. Archived data also may be copied to spreadsheets for patient files.