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)

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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16 comments

    • Mike Knight says:

      Thank you so much, Lisa, I appreciate you reading the piece and your feedback, too. It *is* a lot of money and sort of makes my stomach sink when I think about it.

      I tried to fit this into the piece, but couldn’t make it work: the first real new car (if you want to call it a car) I ever bought was a 1984 Chevy Chevette (I’d swear this was a picture of my exact car…https://goo.gl/images/LfPxtK). The base price according to my research was $5600:-).

      Anyway… Thanks. If I can be of help to anybody else by going through this, I want to be. More soon!

  1. Dale Degraffenreid says:

    Very informative. I will pass this information to my daughter who is having real problems with walking and sitting.

    • Mike Knight says:

      Thank you, Dale, I hope it is helpful to her. FWIW, I get a lot of pain from sitting, also, which seems to get much worse as the day progresses. I don’t know if this is similar to your daughter’s pain or not, but I’m guessing that other folks are experiencing the same sorts of issues. Best of luck and thank you again!

  2. Renee Bricker says:

    Mike,
    I purchased the Bioness L300Go in April. Walk-Aide didn’t work at all for me. (For reasons I never had explained to me, the electrodes burned my leg and seemed to have burned out. (Yikes!)

    My point is that the price tag for the Bioness is dear, but I used CareCredit to do it. https://www.carecredit.com/?dtc=N354&Exact=carecredit&sitecode=CCDTCSEMN354&gclid=Cj0KCQjw-JvaBRDGARIsAFjqkkrS-kKZKaT4AhjYZS_vh2OwV5RF06ioce8JJR7wPRMJl91Raz2AnGAaAlIrEALw_wcB

    It’s interest free as long as you’re ABSOLUTELY on time, then the interest is draconian. I used automatic payment to make sure I’m on time. It’ll be paid for in two years. You can also use CareCredit at the vet. It’s essentially a credit card only for medical expenses. Good luck.

      • Nanette Colomb says:

        Hello Mike and Renee. I purchased my Bioness cuffs (I need one for each leg) with the CareCredit card as well. My 30 days are up on July 15. I am wondering what your experiences have been so far. I feel that they are helping but not quite as much as I thought they might. I am still making a decision about whether or not I wish to keep them. I am having the rep do a re-adjustment in hopes that this helps. And for the record, the used 2001 Chevy Tahoe that I bought 3 yrs ago cost $6,000. Thank you for the article, Mike. Very timely.

        • Mike Knight says:

          Thanks, Nanette. I have not yet been fitted with the device, scheduled for early August at this point (our “clinical specialist“ covers multiple states, and that is as soon as I can get on his schedule). I will write a summary after I’ve had the 30 days with the Bioness, but in the brief time that I used it (15 minutes In a PT office), it did in fact work, though not as well as the very first time I had the WalkAide on my own (at least in my memory…That was in March after all ;-)).

          I’m sorry that is not more helpful given your deadline.

          However, your 2001 Tahoe sounds far better than that old Chevette. Thanks for reading and I wish you the best with your decision!

  3. George Trebaol says:

    I’ve been using a WalkAide for almost two years. After a lengthy trial that I paid for, the evidence became clear to my insurance that it was extremely useful in allowing me to walk. They decided to pay for the device which they had never done before for MS patients. Since then, several other people have succeeded in getting the WalkAide paid for by insurance as an MS device. Getting a professional fitting and calibration is definitely needed.

    • Mike Knight says:

      Thank you, George, that is great to hear. I’m definitely going to appeal to our healthcare company to see if there is any give in their policy. Good to know that it *can* happen. Thanks again!

  4. Ruth says:

    I spoke with a Bioness rep yesterday – am definitely looking into trying this. Keep us informed on your experience! Much appreciated!

    • Mike Knight says:

      Thank you so much, I appreciate you reading the column. I will definitely follow up once I’ve had my 30 day’s in. Good luck on your trial, I hope it works out well for you!

  5. Mary Daykin says:

    I have been using the Bioness L300 system for 4 and a half years. The gate sensor under the foot does NOT have any sensation involved with it. It is simply a sensor that when depressed by your heel sends a signal engaging the stimulator in the shin cuff to stimulate the dorsiflexor muscle to raise the toe so you can walk without tripping. The user is completely unaware of the foot sensor once it is placed under the insole of the shoe. The new GO system doesn’t need a gate sensor to engage the stimulation, but it is still available with the L300 for people who may need it. Bioness L300 has been a godsend for me and I have been able to remain on my feet for a much longer period of time than I would’ve without it. I use a chair now, as well, but the Bioness system still provides me with the independence I treasure and appreciate. Yes, it is expensive, but well worth it for those of us who benefit. I am Canadian, so do the exchange on $6000 USD becomes $8000 CAD.

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