Samtykkeerklæring/ client consent
Jeg bekræfter hermed, at jeg har forstået at jeg træner XBody EMS på eget ansvar.
Jeg erklærer at jeg er bekendt med det grundlæggende i EMS-træningsmetoden (Electrical Muscle Stimulation), herunder alle omstændigheder, der kontraindikerer træningen, f.eks. tilfælde, hvor medicinsk konsultation er obligatorisk eller rådgivet, og de yderligere advarsler og noter, som det er beskrevet i dette dokument.
Jeg erklærer at jeg er i en sund fysisk og mental tilstand, som gør at jeg kan deltage i XBody EMS træning
Jeg erklærer at jeg ikke er bekendt med nogen kontraindikation (beskrevet nedenfor), der kan udelukke mig fra træningen.
Jeg erklærer, at jeg har modtaget alle obligatoriske lægekonsultationer for de omstændigheder, der er beskrevet nedenfor.
Jeg erklærer, at jeg vil overholde reglerne vedrørende forudsætningerne og eftervirkningerne af træningen.
Jeg erklærer at informere min læge og min XBody træner i tilfælde af nogen ændring i min mentale, fysiske og sundhedsmæssige tilstand.
Jeg erklærer at informere min læge eller enhver anden læge, der er involveret i mit helbred, i tilfælde af enhver medicinsk indgriben i min forudsætning for at deltage i XBody EMS træning.
Jeg erklærer at i tilfælde af at jeg udelader eller ikke overholder betingelserne i denne aftale, er det fuldt ud og helt gennem mit eget ansvar at deltage i træningen.
Jeg erklærer at jeg ikke vil holde XBody Ungarn Kft. eller XBody træneren ansvarlig, hvis nogen af mine ukendte psykiske, sundhedsmæssige eller fysiske forhold forårsager bivirkninger eller komplikationer af nogen art.
Jeg erklærer, at jeg ikke vil holde XBody Ungarn Kft. eller XBody Trainer ansvarlig i tilfælde af bivirkninger, komplikationer, læsioner eller uønskede ændringer i min fysiske eller sundhedsmæssige status.
Jeg forstår at langsigtede virkninger af EMS træning er ukendt, og at jeg ikke vil holde XBody Ungarn Kft eller XBody træneren ansvarlig for nogen uønsket effekt.
Jeg erklærer at følge instruktionerne fra XBody træneren før, under og efter træningen.
På grund af nødvendigheden af tæt personlig kontakt, mens man tager træningsdragten af og på, erklærer jeg, at dette på ingen måde kan fortolkes som en seksuel tilnærmelse eller chikane af nogen art.
Jeg er indforstået med, at mine person- og træningsdata vil blive registreret og brugt.
Jeg forstår og accepterer indholdet af alle de ovennævnte erklæringer.
Kontraindikationer:
I nedenstående tilfælde af sygdom eller generelle helbredstilstande er det FORBUDT at påbegynde EMS træning: Man må IKKE træne EMS hvis man er bærer af pacemaker, implanteret defibrillator eller andre, lignende apparater. Man må IKKE træne EMS hvis man har hjertesygdomme eller andre aorta-sygdomme
Det er forbudt at træne EMS hvis man har alvorlige, neurologiske lidelser.
Det er forbudt at træne EMS hvis man lider af epilepsi eller andre medicinsk kontrollerede, krampelignende anfald.
Det er forbudt at træne EMS hvis man har alvorlige, neuro-muskulære lidelser, f.eks Rhabdomyolosis eller andre tilstande, som påvirker nervesystem og muskulatur.
Det er forbudt at træne EMS hvis man har kræftlæsioner, f.eks brystkræft.
Det er forbudt at træne EMS hvis man har alvorlige neurologiske sygdomme.
Det er forbudt at træne EMS hvis man lider af, eller har tendens til indre blødning.
Det er forbudt at træne EMS hvis man har ikke-intakte hudlidelser, åbne sår, infektioner eller andre hudskader. Det er forbudt at træne EMS hvis man er gravid.
Det er forbudt at lave anden intens eller anstrengende træning i 2 dage efter EMS træning.
Advarsler:
I de nedenstående tilfælde er lægelig konsultation obligatorisk og skal kunne dokumenteres før eventuel EMS træning kan påbegyndes.
(Alle usædvanlige, ab-normale fysiske tilstande eller symptomer kræver ligeledes medicinsk/lægelig godkendelse før træning kan påbegyndes)
Lægelig godkendelse skal foreligge, hvis man er bærer af implanteret metal nogen steder i kroppen. Man skal være omhyggelig med at anbringe elektroder således at det ikke er muligt for den elektriske påvirkning at berøre steder i kroppen hvor metal måtte forefindes. Det anbefales endvidere at sætte intensiteten i disse tilfælde på værdi 0.
Lægelig konsultation skal søges hvis man har implantater, f.eks silicone eller gynækologiske implantater. Lægelig konsultation skal søges hvis man lider af for højt blodtryk eller Hypertoni.
Lægelig konsultation skal søges hvis man for nyligt har undergået kirurgiske indgreb eller medicinsk behandling. Lægelig konsultation skal søges hvis man lider af brok eller lignende abdominale lidelser.
Lægelig konsultation skal søges hvis man lider af kroniske sygdomme, feber, smitsomme sygdomme eller akut kroniske infektioner, bakteriel såvel som vira.
Lægelig konsultation skal søges hvis man lider af sukkersyge.
Lægelig konsultation skal søges hvis man har overfølsom hud eller områder på huden hvor man ikke har normal følsomhed.
Lægelig konsultation skal søges hvis man lider af menstruelle kramper.
Lægelig konsultation skal søges hvis man er stærkt overvægtig eller er ekstremt fysisk in-aktiv.
Lægelig konsultation er obligatorisk hvis man lider af mentalt underskud, i hvilke tilfælde træningen skal overvåges af en værge.
Jeg erklærer hermed med min underskrift, at være indforstået med ovenstående retningslinjer og betingelser for EMS træning.
Endvidere:
Børn og unge under 18 skal have deres forældres tilladelse til at træne EMS.
Man bør ikke udføre elektrisk stimulation over nakken, specielt ikke over halspulsåren.
Man må ikke anbringe elektroder på begge sider af hjertet (i.e elektroder placeret samtidigt på brystet og det øverste af ryggen). Dette kan føre til at den elektriske strøm føres igennem hjertet og kan føre til hjerteflimmer.
Man må ikke anbringe elektroder på hovedet eller over øjne eller mund.
Man bør ikke anvende andre elektriske enheder, f.eks pulsmeter, imens man træner EMS.
Man må IKKE træne EMS under indflydelse eller efter indtagelse af alkohol eller andre euforiserende stoffer.
Vigtige Noter:
Læs omhyggeligt nedenstående liste over generelle helbredsmæssige tilstande, som man ikke må have inden eller under EMS træning.
I tilfælde af generel dårligdom, sygdom, svimmelhed eller hvis man føler en stramning over brystet skal du informere din træner og straks indstille træningen.
Hvis du føler varme eller ubehag på huden under træningen, skal du bede træneren om at afbryde træningen.
Reflektive muskelsammentrækninger vil forekomme som resultat af den elektriske påvirkning. Det er derfor vigtigt at du indtager en stabil stilling under træningen.
Drik rigeligt før og efter træning. Hvis du føler det nødvendigt under træningen, bed om en pause og drik vand. Det er vigtigt at have spist et ordentligt måltid et par timer før træning.
EMS træning kan påføre musklerne små brister, hvilket fører til ømhed og kortvarig forhøjet CK-MM niveau i blodet. Dette er en naturlig reaktion i kroppen, p.g.a den meget intensive træning som EMS er.
Hvis du skal have foretaget blodprøver indenfor 24-48 timer efter træning, er det vigtigt at meddele din læge at du har lavet EMS træning. Ellers kan det føre til fejlfortolkning af dine resultater.
Ovenstående sider bekræftes hermed som læst og forstået og at udførelse af EMS sker på egen risiko.
Declaration
CLIENT’S CONSENT
I declare to undergo XBody EMS training willingly and through my own responsibility.
I declare that I am aware of the basics of the Electrical Muscle Stimulation (EMS) training method, including any and all circumstances which contraindicate the training, for instance, cases in which medical consultation is obligatory or advised and the further warnings and notes as is detailed on page 2 of this document.
I declare myself to be able to undergo XBody EMS training with respect to my current mental state, health and physical status.
I declare that I am not aware of any contraindication (described below) that may exclude me from the training.
I declare that I have received any and all obligatory medical consultations for the circumstances described below.
I declare that I will abide by the rules related to the preconditions, aftereffect and the training. I declare to inform my physician and XBody Trainer in case of any change in my mental, physical and health status.
I declare to inform my doctor or any other Medical professional involved in my care, in case of any medical intervention of undergoing the XBody EMS training.
I declare that in case of omitting or noncompliance with the terms of this agreement I undergo the training fully and completely through my own responsibility.
I declare that I will not hold XBody Hungary Kft. nor the XBody Trainer responsible if any of my unknown mental, health or physical conditions cause side effects or complications of any kind. I declare that I will not hold XBody Hungary Kft. nor the XBody Trainer responsible in case of any side-effects, complications, lesions or any undesired change in my physical or health status.
I understand that risks due to the long-term effects of EMS training are unknown, therefore I will not hold XBody Hungary Kft. nor the XBody Trainer responsible for any undesired effect.
I declare to follow the instructions given by the XBody Trainer before, during and after the training.
Due to the necessity of close personal contact while putting on and removal of the Training Suit, I declare that in no way should this be misconstrued to be a sexual advancement or harassment of any kind.
I contribute that my personal and training data will be registered and used.
I understand and accept to be bounded by the contents of all of the above mentioned declarations.
Contraindications
In the following cases of diseases or conditions, it is forbidden to undergo any electrical muscle stimulation (EMS) training or treatment.
It is forbidden to use XBody EMS device, if the client has implanted or external medical device (e.g. cardiac pacemaker, implanted defibrillator).
It is forbidden to use XBody EMS device, if the client has severe cardiovascular diseases (e.g. severe heart or aortic disease).
It is forbidden to use XBody EMS device, if the client has severe neurological disorder.
It is forbidden to use XBody EMS device, if the client has medication-controlled or medication- uncontrolled seizures or convulsions (e.g. epilepsy).
It is forbidden to use XBody EMS device, if the client has severe neuromuscular disorder (e.g. rhabdomyolysis or any disorder that affects the nervous system and the muscles and causes rapid breakdown in muscle structure).
It is forbidden to use XBody EMS device, if the client has cancerous lesions (e.g. breast cancer). It is forbidden to use XBody EMS device, if the client has severe nephrological disease.
It is forbidden to use XBody EMS device in case of existence or a tendency of internal bleeding. It is forbidden to use XBody EMS device in case of non-intact skin (e.g. infected, wounded or any non-healthy, inflamed, irritated or oedematous skin area).
It is forbidden to use XBody EMS device during pregnancy or suspected pregnancy.
It is forbidden to undergo any intensive training for two days after XBody EMS training.
Warnings
In the following cases, medical consultation is obligatory. Any other disease or unusual, abnormal physical condition or symptom also requires medical approval before undergoing XBody electrical muscle stimulation (EMS) training or treatment.
Medical consultation is obligatory in case of metal implants. Make sure that electrodes are used in a way that it is impossible for electrical current to flow through the affected area (e.g. set intensities of such channels to 0).
Medical consultation is obligatory in case of non-metallic or other implants (e.g. silicone implants, gynecological implants).
Medical consultation is obligatory in case of less severe cardiovascular diseases (e.g. hypertonia, high blood pressure).
Medical consultation is obligatory after a recent surgical procedure, medical intervention or acute trauma or during any medical treatment (e.g. drug treatment).
Medical consultation is obligatory in case of any hernia (e.g. abdominal or inguinal hernia). Medical consultation is obligatory in case of chronic disease or fever, contagious disease or any acute or chronic infections (bacterial or viral).
Medical consultation is obligatory in case of diabetes.
Medical consultation is obligatory in case of the client has painful, sensitive skin or skin areas
lacking normal sensation.
Medical consultation is obligatory in case of menstrual cramps.
Medical consultation is obligatory in case of abnormal obesity or extreme physical inactivity.
Medical consultation is obligatory in case of any mental deficit (the client can only use XBody EMS device with guardianship).
I understand and accept to be bounded by the contents of all of the contraindications and warnings.
Furthermore
Parental consent is obligatory in case of underage clients.
Do not apply electrical muscle stimulation over the neck (especially over carotid sinus nerves or carotid artery).
Do not put electrode pairs on the opposite side of the heart (electrodes placed on the chest and the upper back), because the introduced electrical current may flow through the heart which increases the risk of cardiac fibrillation.
Do not apply electrical muscle stimulation on the head (e.g. directly on the eyes or covering the mouth).
Do not apply electrical muscle stimulation together with other electrical measuring instruments applied near on body surface (e.g. pulsemeters).
The client must not be affected by alcohol or drugs during XBody EMS training.
Important notes
Please read carefully the conditions listed below before starting your training with XBody EMS technology:
In case of malaise, ailment, dizziness or feeling aching tightness around the chest or heart area you must inform the trainer to immediately stop the training.
If you feel any hotness or discomfort on your skin during the training, you need to ask the trainer to switch off the device.
There will be reflex-like muscle contraction movements caused by stimulation impulses. Maintain pre-contracted muscles if possible and acquire a stable basic position.
Ensure proper water intake before and after training.
If you feel necessary have a short break during the training and drink a glass of water.
Make sure that you had a proper meal 2-4 hours before your training.
EMS training might cause micro tears in the muscles, which usually leads to muscle soreness, and elevated creatine kinase (CK-MM) level in the blood. This is a natural reaction of the human body to intensive trainings (such as XBody EMS trainings).
In case you have your blood analyzed 2-6 days after your last EMS training it is important to inform your doctor to prevent incorrect misinterpretation of your values.
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