Out on a Stim: The Pros and Cons of FES Devices (Part 2)

Out on a Stim: The Pros and Cons of FES Devices (Part 2)
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mike knight

Part two in a series. Read part one.

The thing about functional electronic stimulation (FES) devices, at least to me, is waiting for them to engage. No matter how much I prepare myself, I’m still surprised — on pins and needles, if you will — when the “stimulation” takes place, the tiny little electronic “signal” (aka: jolt) juicing my foot and toes back into a semblance of the life they once led.

Don’t get me wrong. I like the outcome. I’m just a little anxious with anticipation.

Sort of like this.

It’s a rainy Tuesday morning in June, and I am getting ready to take the Bioness L300 Go for a spin. Given my proclivity for falling, perhaps I should say taking it out for a walk.

In late May, I wrote about “test walking” the WalkAide System over a two-month period. (The trial was originally supposed to be two weeks with a $250 price tag, but I had my time extended and fees waived due to my hesitations with buying the device.) Once I was able to position the device properly on my right calf (my “affected” leg), the results were remarkable. But I struggled to find the device’s “sweet spot” consistently — an issue that is attributable to user error, MS, the device, or maybe some combination of the three.

This is my second go-round with the two FES devices sold in the United States — the WalkAide System and its competitor, Bioness. I tried both more than a year ago, but their $5,000-plus price tags frightened me away from purchasing either back then. My healthcare doesn’t cover the cost of the device, still somehow deeming the decades-old technology “investigative.”

But this last year has brought ever-challenging leg and hip flexor strength issues, along with a torn rotator cuff from trying to climb stairs in stride. In the uncertainty that is MS, I’m torn between the “use it or lose it” philosophy that suggests lack of muscle use leads to atrophy and loss of capacity, and the “conserve your energy so you can use it more efficiently” philosophy that suggests saving my energy only for those things that I truly need, or want, to do.

Like all things MS, there are no guarantees for how well the device will work, nor for how long. But it’s possible an FES device for my foot drop could be useful.

I’m cautiously eager to try the L300 Go. Here’s why: Unlike last year’s model, the L300 Go does not require an “electrode” under the sole of the user’s foot as the stimulation “delivery point.” The sole stimulation is a sensation I could not get used to.

There are other differences between the two brands. The WalkAide System employs two gel-type electrodes to deliver the stimulation signal, and they must be properly positioned for the device to work. Bioness integrates its electrodes within a soft pad inside the cuff, which then secures against the user’s calf muscle. The Bioness cuff is a bit more streamlined in appearance, and, as the Bioness clinical specialist straps it to my leg, it doesn’t seem to have to be worn quite so snugly to work.

Technologically-speaking, the Bioness touts other features, too, including something called “3D Motion Detection,” which, according to the company’s website, detects “gait events, providing stimulation precisely when needed making it easier for users to clear their foot at different walking speeds, on stairs, ramps, and while navigating uneven terrain.” It also features a home user app that lets users track their steps and other similar milestones, plus establish goals.

Bioness also offers a range of other products to help people with stroke, MS, and other central nervous system issues.

What Bioness doesn’t offer is a free trial period to see how — or if — the device works consistently for me over an extended period. Instead, I must purchase the device at a cost of $5,530 (discounted from about $6,200 because my insurance doesn’t cover it), and meet again with the clinical specialist to have it fitted and programmed for my needs. I then have 30 days to use it before notifying the company whether I would like to return it. Once I’ve notified the company that I want to return the device, I have 14 days to get it back to them before being refunded the cost of the device minus a $595 “restocking” charge.

Once we get the cuff in place and programmed, I pull myself up out of my chair, grab my cane, and take a tender first step, waiting for its magic. When I’ve got my feet under myself, I place my cane against the wall and walk through the offices — unassisted.

$5,530 is a lot of money to my wife and me, and a cost we had not anticipated. But it is very hard to put a value on being able to walk for just a little longer and to do so a little bit easier, maybe even a little bit better.

So long, $595.

I’ll write more after I’ve had my 30 days.

Stay tuned.

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