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As an NMES device, indications are for the following conditions:

-Relaxation of muscle spasms

-Retardation or prevention of disuse atrophy

-Increased local blood circulation

-Re-Educating muscles

-Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis

-Maintaining or increasing range of motion.

As a TENS device, indications are for the following conditions: -Symptomatic relief and management of chronic intractable pain -Adjunctive treatment for post-surgical and post-traumatic acute pain

TimeWaver Frequency is an electrical stimulation device that supports the treatment of specific medical conditions, using currents in the microampere range with different frequencies. It can be applied to different areas of the body and is a multifunctional electrotherapy device with two stimulation channels and two treatment modes that deliver neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulations (TENS).

The TimeWaver Frequency device is a prescription device intended to be used by healthcare providers in a healthcare setting and is not approved for use in a home environment. The use of the device on a particular patient is solely the decision of the medical professional, who is responsible for having the proper training and exercising his or her informed medical judgement.

The principals of electrotherapy correspond to the process observed during voluntary muscle contraction. NMES pulses stimulate motor points of target muscle contraction. This can help reeducate and strengthen muscles following injury or surgery. TENS blocks the pain signal sent from the affected area on nerve pathways.

The TimeWaver Frequency device provides 6 treatment programs for NEMS and two treatment programs for TENS. The NMES programs are for relaxation of muscle spasms, disuse atrophy, blood circulations, re-educating muscles, stimulation of calf muscles, and range of motion. The TENS programs are for chronic pain and acute pain. In all modes adhesive electrodes are used to deliver the stimulation.

The TimeWaver Frequency is controlled by an application software program. A personal computer or a notebook is necessary to install the application software and is not provided with the TimeWaver Frequency system. The TimeWaver Frequency software must be used as a stand-alone application on its own computer, which is not used for other software applications. The user interface has several sections. The title bar contains the current program version, the lower status bar shows if hardware components are correctly connected, and the menu bar allows selection of the section to work within. The software requires setting up a new client to include relevant patient information. Treatments are conducted by selecting the appropriate treatment from the Programs module.

The TimeWaver Frequency device operates using an external power supply and/or an internal battery. It is supplied with instructions for use, the TimeWaver Frequency device, power supply, USB cable, electrode connector cables, 50mm x 50mm and 50mm x 90 mm adhesive electrodes.

Sorry, but the provided text from the FDA 510(k) submission for the TimeWaver Frequency device ({0} through {14}) describes a substantial equivalence determination based on non-clinical testing and comparison to a predicate device, rather than a study with acceptance criteria and reported device performance in terms of clinical outcomes or diagnostic accuracy.

The document states:

• "TimeWaver has completed comprehensive design verification testing, electrical safety and electromagnetic compatibility testing, software verification and validation to ensure that the TimeWaver Frequency device performs as intended." (Page {5})
• "All necessary non-clinical testing was conducted on the TimeWaver Frequency device to confirm that the device performs as intended." (Page {13})
• The enumerated nonclinical tests include electrical safety and electromagnetic compatibility, biocompatibility verification, and software verification and validation. (Page {14})

There is no information within the provided text about:

• Acceptance criteria related to clinical performance (e.g., sensitivity, specificity, accuracy).
• A study specifically measuring device performance against such criteria.
• Sample sizes for a clinical test set or data provenance.
• Number of experts, their qualifications, or adjudication methods for ground truth.
• A multi-reader multi-case (MRMC) comparative effectiveness study or related effect sizes.
• A standalone algorithm performance study.
• The type of ground truth used (expert consensus, pathology, outcomes data).
• Sample size for a clinical training set or how its ground truth was established.

The FDA 510(k) clearance process for this type of device (Powered Muscle Stimulator and Transcutaneous Electrical Nerve Stimulator) often relies on demonstrating substantial equivalence to a legally marketed predicate device through engineering and performance bench testing, rather than new clinical trials demonstrating efficacy or safety if the indications for use and technological characteristics are similar and do not raise new questions of safety or effectiveness.

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