Columns The MS Wire - A Column by Ed Tobias I Give the L300 Go a Mixed Review I Give the L300 Go a Mixed Review by Ed Tobias | August 21, 2020 Share this article: Share article via email Copy article link I’ve been walking with the Bioness L300 Go for about eight months, so it’s time to update everyone on how things are going. The L300 Go is a functional electrical stimulator (FES) that helps counter my foot drop. MS has damaged the nerve that carries the message telling my left ankle to flex upward and lift my toes as I walk. The L300 Go senses when my left leg starts to move forward. Through a cuff strapped below my knee, it sends a low-intensity electrical pulse to the nerve, ordering my ankle to flex up and lift my toes. The Go is an upgraded version of the original L300. I started using the original device in October 2012. Shortly before the Go became available in 2017, I gave it a test walk. But I didn’t want to spend $4,000 on the trade-in cost to buy one. The L300 isn’t covered by most commercial insurance policies, Medicare, or Medicaid. But because Bioness was phasing out support for the older unit, I tried the Go again last December. This time, I decided to bite the financial bullet and upgrade. Mixed results for the L300 Go The best thing about the L300 Go is that it doesn’t require a sensor in my shoe like the older model. That means I can easily change shoes or even use the cuff while I’m barefoot. The lack of this sensor, however, means there’s a little relearning curve. With a sensor, the electrical pulse would fire as I lifted pressure off my heel. Without the sensor, the pulse reacts to leg movement rather than heel pressure. So, the pulse seems to begin later and last longer. I also need to walk a step or two until the unit’s three-axis gyroscope and accelerometer learn what my leg is doing. The folks at Bioness say this allows the unit to adjust for different walking speeds and surfaces, but I’m not sure that it really does. At least, I don’t notice it changing. The Go, like the original L300, also is inconsistent. Its placement on the leg must be just right, and after using one for nearly eight years, I’m still not sure where to put it each time I strap it on. Sometimes I have to try two or three spots. My leg also has to be clean and can’t have any kind of lotion or soap residue on it. The electrodes seem to be very sensitive about skin conductivity. The Bioness L300 Go. (Photo by Ed Tobias) What do other users think? Earlier this month, a reader with secondary progressive MS who knows I use the L300 asked for my opinion of it. She’s been testing one and says she can’t use it for more than two hours because it overstimulates her leg. Changing the type of electrodes and having the unit’s intensity adjusted several times hasn’t helped. She’s not sure the device is worth spending upward of $5,500 and is thinking of trying an ankle-foot orthosis instead. She wondered if different people have different results with the L300. She may be right. Coincidentally, a few days ago, a 74-year-old reader in Belgium also sent a note about a column I’d written about my L300 Go, but his reaction was different. The reader, diagnosed with MS about a decade ago, said he’s been using the L300 device for five years, and he can’t be without it. He uses it to walk distances greater than 50 meters, he wrote. I fall in the middle of these two opinions. I used my original L300 frequently when I first got it, but less as my MS progressed. When I got the L300 Go, I also used it a lot. If I went to a restaurant, for example, I used it to walk from my parking spot rather than riding my scooter. Since last March, trips anywhere have become few and far between. It hasn’t been worth it to fuss with the cuff on most days. If I have to walk a short distance, I use my two canes and drag my leg. I know that I walk better using my L300 Go. When I do a 25-foot walk test for my neurologist, I walk significantly faster when I use the cuff. If I can walk faster and use less energy, I should probably use the cuff more. Maybe if the world ever returns to normal, I will. You’re invited to visit my personal blog a www.themswire.com. *** Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis. Print This Page About the Author Ed Tobias People say to write what you know and Ed Tobias knows about MS. He's lived with the illness since 1980, when he was 32 years old. Ed's a retired, award-winning broadcast journalist and his column combines his four decades of MS experiences with news and comments about the latest in the MS community. In addition to writing his column, Ed is one of the patient moderators on the MS News Today Facebook, Twitter, and Instagram sites. He’s also the author of “The Multiple Sclerosis Toolbox: Hints and Tips for Living with M.S.” Ed and his wife split their time between the Washington, D.C. suburbs and Florida’s Gulf Coast, trying to follow the sun. Tags Bioness L300 Go Comments Kathy Allen Thanks for your review.I have never read any reviews!! I have the original L300. I also am no longer using it. I have belonged to MS Gym for 2 1/2 years & my foot is lifting up on its own (most of the time)!! As to your comments about the sensitivity of the placement of the electrodes, the orthotist 'played' around with it for years & I thought it was pretty good but then after the physiotherapist with the company watched me walk on video, she recommended that the electrodes be placed differently - she had been difficult for the orthotist to contact. I think the difference was everters & inverters. So, again, thank you for your review, I wondered about purchasing. Kathy Reply Ed Tobias Hi Kathy, Thanks for your comments. It's interesting that you mention the MS Gym. I've almost joined a few times since it began, two or three years ago. I've never done it because the constant emails that I get from Trevor are a turn-off, rather than an encouragement. However, since it helped your foot drop I may look into it again. (It's certainly less expensive than an L300, or even a standard AFO). Ed Ed Reply Christine Paul I found my experience with the L300 to be similar to yours. I’ve had mine around 2 years. When seated properly, it did allow me to walk faster and more safely instead of struggling to lift my toes. But getting it in exactly the right place was hit or miss. And because of the way it sensed motion, it was fairly useless, not to mention distracting, on stairs. I had to set the intensity of the pulse to 4, one less than the PT recommended or it set my teeth on edge. And because I needed to constantly adjust it, or turn it off and on, unless I was wearing shorts, I stopped using it. So I would wear it occasionally if I needed to walk any further than 25 feet, which I can manage with a cane. My husband tells me there is a noticeable difference in my walking when using it, but I find myself avoiding it because of the issues described above. Worth it? No from my perspective. I wish I had spent the money on a better scooter. Reply Ed Tobias Thanks for your perspective, Christine. Yes, it sounds as if our experiences are very similar, though I've never had an adjustment that was way too high. It's usually the opposite for me. I'm about to strap mine on now because I need to do some walking from my car into a scooter place. The scooter needs new batteries. Nothing's perfect. :-) Ed Reply Michael Carter I have had the l300 for about a year now, but I keep battling skin irritation on my leg, any suggestions on being able to use it without the skin irritation. Reply Ed Tobias Hi Michael, The L300 Go's manual mentions a few things, including: Cleaning the skin with soap and water and rinsing well before putting the cuff on. Dampening cloth based electrodes before using and every 3-4 hours after that. Removing the cuff for at least 15 minutes every 3 - 4 hours, regardless of the kind of electrode you're using. I think the most important of these, though honestly I don't follow the recommendation, is removing the cuff every few hours to give the skin a break. Do you know there are three different kinds of electrodes you can use: gel, cloth and quick-fit (which are also cloth)? Maybe changing the type you use will help. The problem here is that some these need to be replaced more often than others, and that can be expensive. I hope this helps a bit. Ed Reply Marissa Mandell Hi Ed. Thank you for your review. It’s so helpful for me to hear about other people’s experiences with using Bioness, and I wanted to share my experience. I have been using the L300 Go Plus System since this past March. It activates not only my ankle flexor, but my hamstring as well. Several years ago I used the Walk-Aide which stimulated my ankle flexor only. Ultimately it didn’t help me, because my drop foot is caused as much by a weak hip flexor as it is by weakness in my ankle flexor. Although the Go Plus doesn’t activate my hip flexor specifically, it activates my hamstring which allows my leg to compensate. Since I’ve been using the Bioness system I’ve been learning better walking patterns and I’m regaining strength in my leg and ankle. It’s double the cost of the ankle cuff alone, and there’s certainly a learning curve involved in using it. But I think it’s something worth giving a trial run. P.S. Like Kathy, using the MS Gym has been helpful for me too and I also think it’s definitely something worth checking out! Reply Ed Tobias Hi Marissa, Thanks for adding this great additional info. I'm sure it will help all of us. I tried the Walk-Aide back when I first looked into the L300 and I didn't feel as comfortable using it as I did with the Bioness. I think that a lot of my problem is also a weak hip flexor, but I tried the L300 Go Plus and it didn't seem to do anything to help when I tried it in the clinic setting. Another vote for the MS Gym, I see. I guess I really should give it a try. Ed Reply Cari W I realize that this is an older post and you may have already solved your issue. When I participated in a Bioness trial, I had a terrible skin reaction that actually took on the shape of the device where the hard plastic touched my leg. After some time, the company acknowledged that they were aware that some people reacted to the material and they offered an alternative model with a different material. I had already made up my mind to get a Walkaide, so I did not try the newer version. But this information may be helpful to you or others experiencing skin irritation with the Bioness. Reply Ed Tobias Thanks for this info, Cari. I'm sure it will be useful to others even though this column was published a while back. Ed Reply Desiree I also had terrible skin issues. At one point I had some skin to slough. I used mole skin on all contact surfaces, which helped but not enough. Reply Susan Heckly I used a WalkAid device (similar to the Bioness) for 7 years very successfully. It kept me walking. Early this year, it died and they were not able to fix it. I needed to get another prescription for a FES product and was encouraged to try Bioness. Long story short: I ended up with the Bioness L300 Go and I am not nearly as happy with it as I was with the WalkAid. It is harder to put on, it is harder to fine-tune the impulses and it's not as comfortable. I don't like the recharging need every night. WalkAid had a battery that lasted many months. The WalkAid gel electrodes were a little harder to replace, but lasted longer and didn't stick to my leg when I took the unit off. My insurance certainly won't partially pay for a second device, so I may end up footing the bill for a new WalkAid when I just can take the Bioness anymore. Reply Ed Tobias Hi Susan, Thanks for sharing that info. I tried a WalkAid before I got my original L300 and I didn't feel as stable with it as I did with the Bioness. But, if I ever get to the point where the L300 Go needs to be replaced you've encouraged me to try the WalkAid again. But, your insurance paid for some of the L300? Wow!! Sign me up. Ed Reply Carol Jean DeGroot, MS since 1978 Hello, My name is carol jean. I started Medicare September 1st. Thank you for your conversations regarding the WalkAide and Bioness systems. I tried both systems before purchase. Insurance paid 100% for WalkAide after 3X denial, "approved only for foot drop from stroke". My HR person pointed out my insurance was employer self funded and I should not have been denied so that is water under the bridge but pointing out for others that if your insurance is a self funded policy your device and many other benefits are covered even when the insurance says denied, so appeal. I started the WalkAide system 2010 as it was easier to work with the company representatives and I liked the option of not having to wear a device in my shoe (Bioness). My device has not "died", but one light is no longer functional but does not impair the working order of the entire device. For many years I wore the device full time for work as a RN instructor and consultant. 12 hour days on my feet. I can tell the device improves my walking and stamina. It is fairly easy to conceal beneath loose pants and skirts. I wear it has my badge of honor with shorts. Most people see it as an athletic device until I tell them it is for foot drop. I retired 2018. So now I wear for long walks. I participate in the MS Gym online exercises too. Reply Ed Tobias Thanks for all that useful info, Carol. I'm sure others will be interested in your experience and, especially, your advice about self-funded insurance plans. Also, 10 years is a really good lifetime for any kind of medical device, as you should know. Regards, Ed Reply Lori Foster I am new to the bioness L300 GO. I have a meeting with a rep 7/20 to try it. My question is, does this device help with quad weakness? I also am concerned with the spasticity in my leg. I hope the stimulation doesn’t stiffen my leg up. Any advice? Thank you, Lori Foster Reply Ed Tobias Hi Lori, These are good questions for the PT who will be adjusting the device that you'll be trying. As MS is different for everyone, so is the response to the L300. I can say that my legs are very stiff from spasticity and the L300 doesn't impact them one way or the other. I hope the L300 helps you, but it will take a good deal of trial and error and also getting used to the sensation. Ed Reply Renee Mitchell Hi Ed, I’ve been reading your articles about the Bioness L300 Go for more than two years now. I was dx with MS in 1985, and am now in SPMS with foot drop on left side. I bought the Go in 2019 and it works pretty well for me. I actually I depend on it when I’m away from home. My problem is that the EPG on it went bad about a year ago. It was still under warranty so Bioness replaced it. Unfortunately it seems to have quit on me again and of course, it’s no longer under warranty. Have you heard of this happening to anyone else? I can’t afford to spend another $6000 on another one so soon after buying the first. I will call Bioness tomorrow and hope they can help. Thanks for any comments or suggestions you might have. Reply Jennifer Laymon I have MS and deal with foot drop big time on left side. I’ve had my Bioness L300 for 6 months now. I have both LC and UC. Having these devices have changed my life. I’m not falling while walking anymore! I function in my normal life so much easier. I use my scooter chair if I’m going to be at an event that will require a lot of walking like shopping at a mall or going to a festival etc. but in my day to day life these devises allow me to function without my scooter chair. Some days my intensity level can be be lowered & some days I need it higher. I live in Florida so I’m in shorts 95% of my life but I just spent 2 weeks up north in the cold & I can see for people wearing pants would find them difficult. So I’m thankful I live in a climate where shorts are the majority of my time. Yes I have to adjust some days more then others on placement but I find that a small price to pay for the freedom I gain from it. Also thankful I’m in shorts the majority of my life cause I take my devices off several times a day to give my leg a breathing break. Wearing pants did make that more difficult. I’m paying for mine out of pocket. I was able to get Carecredit. This gave me 18 months zero interest. So my plan is to pay it off in 18 months. For me it’s been worth every penny. The freedom I’ve gained is priceless to me. Reply Ed Tobias Hi Jennifer, Thanks for all of that info and I'm really glad you're doing so well with the cuff. I'm in Florida 6-7 months of the year and the other months are summertime in MD. I'm also retired so I'm in shorts 95% of the time. (Ain't it great?) I can, however, fit the cuff under most of my long pants. Since I wrote this column a couple of years ago I've used the cuff off and on. It really depends on what I'm doing. If I have to walk more than about 100 steps I use it for sure. It doesn't help me as much as it did several years ago, but I suspect most of that is due to disease progression, not the cuff. Ed Reply sarali I also tried the MS gym and liked a lot about it. A lot of it felt kinda sermon preachy. Same feeling about too may emails. Also when they offered an up charge experience that they touted as very helpful I wrote in - a polite note about how i felt a bit offended as a member, Give me all the info for my membership fee. I received a sort of mean spirited reply from Trevors partner about Trevor doing so much and running a business during covid I do so much and was running a business during covid as well I quit when my year was up. They didnt ask why. Reply Ed Tobias That's interesting, Sarali. Thanks for sharing. When the MS Gym began, several years ago, everything was free. Then they started charging a membership free but still provided some boilerplate content for free. Many people speak very highly about it but I never joined. I suspected I'd have the same reaction you had. Ed Reply yee ling wong we bought the bioness 300 used off ebay and am looking for some one to help us set this up. we are in ontario, canada. near toronto. can you help ? Reply Ed Tobias Hi Yee, If you buy the L300 from Bioness a doctor's prescription is required. The reason is that the L300 is considered to be a medical device. Each unit is adjusted by a physical therapist, trained by Bioness and using a special device, to match the physiology of the individual user. Although you can adjust the intensity of the electric pulse yourself, it is impossible for you to make the necessary adjustments that involve the duration of the pulse, or when it starts and stops. These are based on your stride and can only be done with special equipment. Ed Reply Leave a comment Fill in the required fields to post. Your email address will not be published. Your Name Your Email Your Comment Post Comment
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