For the vast majority of us who have not suffered a stroke or a spinal cord injury, simple activities such as walking, cooking, and getting dressed are performed without much thought. However, for many patients with neurological disorders affecting the function of the arm, hand, and legs, these tasks can be nearly impossible.

Functional electrical stimulation (FES) can dramatically assist these patients in facilitating strength, mobility, and independence. Bioness Inc, Santa Clarita, Calif, has introduced two innovative FES systems: the NESS® H200™ Hand Recovery System and the NESS® L300™ Foot Drop System. In both systems, reproducible electrode placement has been simplified by placing the electrodes in compact devices which enables surface stimulation to activate the muscles affected by stroke or injury.

A microprocessor allows the therapist to program the devices with a sequence of exercises customized for each patient's therapy program. With the touch of a button on the small control unit, the therapist or patient can send low-level stimulation to the nerves that activate muscles to perform specific functions.

A HELPING HAND

The NESS® H200™ Hand Recovery System, which features a self-adjusting fit and holds the wrist and hand in a functional position.

The NESS H200 is a noninvasive stimulation device worn on the forearm and hand that may enable patients to perform everyday activities that were previously impossible. The NESS H200 can help the hand open and close, may reduce stiffness, may increase range of motion and strength, may improve circulation, and may assist in regaining awareness of an impaired limb.

The H200 device incorporates a self-adjusting fit to hold the wrist and hand in a functional position. This fit, coupled with the H200 electrode placement, allows patients to remove and replace the device without compromising therapy effectiveness. Also, the patented technology behind the H200 provides seven different stimulation programs which may enable patients to perform a variety of functional tasks as well as therapeutic activities. The system is also versatile enough to be used in various settings, including the clinic and home.

Clinical research has examined the gait and hand function of stroke survivors following training with FES systems. In one 3-month study, stroke patients in the control group received individual instructions for functional training and self-exercised up to 60 minutes twice daily. The FES group received home-based self-administered electrical stimulation training using the NESS H200 Hand Recovery System, a leg orthosis-stimulation device and an arm FES device. Results showed that the group using the FES systems improved significantly more than the control group in light-object lifting, walking time, and walking speed.¹

STEP BY STEP

The wireless NESS® L300™ Foot Drop System, which features a built-in sensor.

The NESS L300 Foot Drop System is a wireless FES system designed to help patients with foot drop to clear their toes while walking and may replace the need to wear a rigid ankle foot orthosis (AFO). The NESS L300 is a low-profile device worn on the lower leg and foot that may enable easier, more natural walking and an increase in community participation.^2,3 The NESS L300 may also facilitate muscle re-education, prevent/retard disuse atrophy, maintain or increase joint range of motion, and increase blood flow.

The NESS L300 uses proprietary technology that may help patients not only walk smoother, but faster as well.² The NESS L300 has a built-in sensor that takes into account the type of surface patients are walking on and adjusts stimulation accordingly. There are no bulky wires to deal with, and the compact design allows patients to wear their normal footwear.

During the swing phase of walking, the NESS L300 sends low-level stimulation to muscles in the affected leg to provide dorsiflexion of the foot. The system includes a leg cuff with stimulation unit, the patent-pending Intelli-Sense™ Gait Sensor, and a remote control that communicates wirelessly, eliminating cumbersome wires used in traditional FES systems. While the patient walks, the gait sensor detects whether the foot is in the air or on the ground, and wirelessly transmits the information to the stimulation unit so that activation of the foot may be smooth and synchronized.

The NESS H200 and NESS L300 are being used throughout the country with positive results in both inpatient and outpatient rehabilitation settings, as well as in the home. Through these and other medical innovations, Bioness strives to deliver advanced technologies that help patients and families address the effects of neurological disorders. For more information, visit www.bioness.com.

Arati Murti is the editor of  Physical Therapy Products. For more information, contact .

REFERENCES

1. Alon G, Ring H. Gait and hand function enhancement following training with a multi-segment hybrid-orthosis stimulation system in stroke patients. J Stroke and Cerebrovascular Diseases. 2003;12:209–216.
2. Hausdorff J, Ring H. The effect of the NESS L³⁰0 neuroprosthesis on gait stability and symmetry, (abstract). J Neurol Phys Ther. 2006;Dec 30:195–200. (Included in CSM 2007 Platform Presentations).
3. Hausdorff J, Ring H. The effect of a new lower-limb neuroprosthesis on physical and social functioning, (abstract) J Neurol Phys Ther. 2006;Dec 30:209–222. (Included in CSM 2007 Platform Presentations).

NESS, NESS L300, NESS H200 and Intelli-Sense are trademarks of NESS Ltd. Ra'anana, Israel | Manufacturer: NESS Ltd. | North American Distributor: Bioness® Inc. | Bioness is a registered trademark of Bioness Inc., Santa Clarita, Calif.