What are patients’ experiences with NESS' devices?
Based on correct indication and accurate formulation of the therapeutic goals, experiences with this device are positive. Many patients are very pleased to be able to perform simple daily activities by themselves once again, such as getting dressed or washing their hair or just walking to the grocery store. Others are pain-free and find that their arm/hand has a more natural appearance or that their gait is more natural and safe.

My illness makes it hard for me to learn new actions. Is operating NESS' products difficult?
Our devices have been specially developed for patients who have had a stroke or suffer from upper motor neuron lesions. Everything has been done to make the products user-friendly and applicable with one hand. Many fellow sufferers confirm that the NESS' products are easy to use. After brief instruction, care workers and family members of the patient can also initiate and supervise treatment.

How much time does the therapy with the NESS H200 take?
Depending on the therapeutic goals and the patient’s capabilities, a suggested therapy schedule is drawn up. Usually, patients use the NESS H200 approximately for two to three sessions of 30-40 minutes per day. In time, fewer sessions per day may suffice to retain the effects.

What are the possible benefits from NESS' Rehabilitation Systems?
These systems may improve function and voluntary movement, increase range of motion, reduce stiffness, increase local blood circulation and prevent or retard muscle weakness in the affected extremity. In addition it may help the brain to relearn how to use certain muscles and help to regain awareness of the impaired limb.

When is it appropriate to begin using a FES Rehabilitation System from NESS?
Barring any contraindications to electrotherapy (i.e. pacemakers, pregnancy) a patient can begin FES training as soon as he or she is medically stable.

Therapy can be implemented throughout the continuum of care. Preferably, therapy can begin during in-patient rehabilitation, with the goal for patients to use the device in a "therapy-directed" home program.

H200 or L300 training and use can be initiated concurrently with traditional occupational and physical therapy techniques and modalities for weak or paralyzed upper limbs. Introduction or continued use of an FES system may also be beneficial concurrent with other medical treatments, such as botulism toxin injections to reduce spasticity in the affected limb.

Patients with chronic disabilities (1 year or more post-injury to the central nervous system) have demonstrated improvements in upper-limb and lower-limb function and impairments including reduced spasticity, muscle re-education, increased active and passive range of motion, increased local circulation and improved function.

How long might a patient benefit from NESS' FES Systems?
Many factors will affect the clinical outcomes, including severity of primary impairments, age, time since stroke, co-morbidities, pre-existing conditions, patient compliance and overall cognition. In turn, treatment objectives will vary depending on whether the goals are to manage impairments versus improve functional outcomes.

Patients with chronic disabilities may use FES for the rest of their lives to manage and/or minimize their impairments.

Patients who begin a Bioness FES rehabilitation system in the acute or sub-acute phase will continue to use the device as long as they are showing improvements in limb function. Depending on the extent of their central nervous system damage they may need continued use to manage their impairments.

What is the motor recovery model?
The motor recovery model is based on the model of neuroplasticity. With appropriate input, formation of "new" neural networks, as well as "up regulating" existing pathways, can facilitate motor recovery.

Repetition, central nervous system (CNS) input, and task training are key components of a motor recovery program.

Response of the CNS is "use-dependent," which means movement and "goal-directed" activation of the affected limb can facilitate motor learning.

"Plasticity" has been shown to occur in both unilateral and bilateral areas of the brain.

How does the FES rehabilitation system compliment the motor recovery model?
Unlike other FES systems, the H200 and L300 integrate easily with traditional rehabilitation approaches enabling therapists with more control over treatment.

Repetitive stimulation to the peripheral motor and sensory systems provides valuable direct and indirect input to the central nervous system.

The unique design of the H200 and L300 Systems allows for a high volume and repetition of interventions.

By activating weak or paralyzed muscles with unique functional stimulation patterns, the H200 and L300 often allow patients to perform goal-directed and functional limb activities.

Can any occupational or physical therapist evaluate and treat a patient with a NESS FES System?
No. A patient needs to be evaluated at a healthcare center which has completed NESS' clinical training program and that has the training devices to evaluate whether the patient will benefit from FES treatment.

What is the role of the therapist in the FES system patient assessment and training?
Working from a physician's referral and prescription, the therapist evaluates the patient to determine if the patient is a suitable candidate.

The therapist:

• Custom fits the Orthosis to ensure the electrodes are properly positioned over the desired motor points or motor neurons.
  
• Selects the parameters for proper stimulation intensity and duration.
  
• Trains the patient to don the Orthosis and operate the Control Unit.
  
• Suggests functional activities to perform while using the system to facilitate potential neuromuscular re-education.
  
• Monitors progress at regular intervals to assure desired patient outcomes are being achieved and revise the home program as needed to maximize continuing progress.

• The NESS H200 System offers a number of advantages over other systems in design and function.
  
• Custom fitting allows the H200 Orthosis to be repositioned perfectly each time by the patient.
  
• The patient is able to accurately and independently re-apply the Orthosis with the use of only one hand.
  
• The H200's five (5) electrodes stimulate and activate the hand to grasp and release while performing real-life, functional activities.
  
• Therapeutic treatment programs and functional modes are pre-programmed into the H200 microprocessor, providing the clinician and patient control over the desired hand activation.
  
• Ergonomic design improves patient/caregiver compliance.
  
• The Orthosis supports the hand and wrist in a position of function. 

Is there research to support the NESS H200?
The NESS H200 is an evidence-based approach to stroke rehabilitation. Published clinical studies in peer-reviewed journals have demonstrated efficacy of the H200 throughout the continuum of care including:

• Improved hand function in select persons with spinal cord injury and post stroke.  
  
• Improved functional outcome measurements with (versus without) the H200.
  
• Improvements in upper limb impairment outcomes.
  
• Functional improvements based on time to complete tasks.

• The NESS L300 system offers a number of advantages over other systems in design and function.
  
• Provides close to natural active movement during gait.
  
• Wireless system allows patients more freedom of movement.
  
• PDA interface enables data storage, retrieval and customization.
  
• The NESS L300's Orthosis allows for easy reproduction of electrode placement. 
  
• Can be donned or taken off with a single hand.
  
• Activates the muscles in a physiological pattern thus providing more natural gait.  
  
• Facilitates voluntary movement, may help to prevent atrophy and improve blood circulation and peripheral metabolism.
  
• May prevent development of compensation patterns.
  
• Allows flexibility of the ankle joint and foot thus aiding in preventing contractures. 
  
• Enables increased walking speed, improved balance and ability to walk on uneven surfaces.
  
• Adjusts real time to changes in speed or terrain.
  
• Fits more comfortably than other products.
  
• Is more cosmetically acceptable due to its low-profile design.
  
• Compatible with everyday footwear.