It’s hard to argue with the benefits of electrical stimulation for people with spinal cord injury. Clinical studies and decades of use have shown that using electrical currents to fire muscle fibers can have a multitude of benefits, from cardiovascular health, to reduced spasms, pain control, improved circulation and bone density maintenance. Recently, clinics have even been using e-stim combined with activity-based therapy and other treatments to help users recover function.
The problem with the technology has always been with how it’s administered. E-stim units are often expensive and/or complicated, requiring all but the most dedicated, supported and knowledgeable users to go to a clinic or rehab gym. But there’s a new product on the market that’s already changing the stimulation calculus: the PowerDot.
The initial incarnation of PowerDot is a small, user-friendly e-stim system that works through an app on your smart phone. Rob Lozuk, the general manager for PowerDot’s medical division, says the device empowers users to do things that previously required a visit to a doctor or therapist or “convoluted instrument with wires at your house.”
“We’ve taken that, put it in the size of a CD case, made it Bluetooth enabled, and you can use it anywhere in the world, any time,” says Lozuk.
PowerDot launched its consumer units in 2016, focusing on athletic performance, pain management and recovery. I used e-stim in my previous life, as a wheelchair rugby athlete, but the available units were clunky and complicated, so I only used them intermittently. I have been trying out the PowerDot for a month, and I can say that the unit performs as advertised: It’s just as functional but far easier to use than any unit I’ve used before. The app is simple and intuitive, and the pads and the transmitter are easy to manipulate, even for someone with reduced hand function. The only wires are those that go from the transmitter to the individual electrodes, and they secure to the electrodes easily via magnetic snaps.
I’ve tried the PowerDot for a couple of different uses — from pain management to post-workout recovery. I don’t have much chronic pain, but when my PowerDot arrived, I’d been dealing with neck stiffness and soreness, the result of some seating issues in my everyday chair. The first time I used it was after coming back from a few miles of pushing. My neck was yelling at me, so I got out the PowerDot and opened the app on my smartphone. In the program, I clicked “Wellness” and then scrolled down to “Neck,” which then gives three options for different types of massage. There’s a picture showing where to place the electrodes on your body. Once set up, I started the massage and then used the simple plus/minus system to dial up the intensity level to my comfort level. If you’ve never used e-stim before, the sensation is a bit strange at first — it is electrical currents zapping your muscle fibers after all — but once you get used to it, the gentle alternation of contract and relax is quite pleasant. After the 30-minute massage, I noticed my neck was looser and less painful. I’ve continued to use the massage feature with positive results.
Another long-standing use of e-stim is for active recovery following a workout. It’s often used by elite-level athletes who are stacking workouts atop each other, and need a way for their muscles to recover faster for the next go around.
Still, you don’t have to be an elite athlete to benefit. Using e-stim as part of a shoulder recovery routine makes a lot of sense for active wheelchair users. We all know that the act of pushing a wheelchair works the fronts of the shoulders more than the back. Stimulating your shoulders a few times a week promotes circulation and helps fire the often-neglected posterior shoulder muscles. It’s not a replacement for balanced strengthening work, but could be a valuable addition to a shoulder care routine.
PowerDot’s literature advises not to use the electrodes on any muscles with reduced function or sensation, and there is good reason for that — if you dial up the intensity without proper sensation, it’s possible to give yourself an electrical burn. There are countless studies vouching for the benefits of e-stim on paralyzed muscle, but to get into the interesting side of the technology, you’re going to need some professional help at the start.
In the Clinic
Adapt Movement is what might best be described as a holistic rehab center for people with neurological disabilities. Based in Carlsbad, California — only a few blocks away from PowerDot’s headquarters — Adapt provides mental health, massage, exercise-based and activity-based rehab and community building programs. The center has been using PowerDot’s soon-to-be-launched medical platform in its gym. Adapt connected with PowerDot by the happenstance of location but quickly saw the advantages offered by its portability and functionality. Not having to be connected to a large cart with wires, like with traditional stimulation units, offers a lot of flexibility. “We’ll weave it into our activity-based or exercise-based recovery sessions, where we’ll take 10 or 15 minutes to do stim on particular muscle groups we’re trying to activate,” says John Monteith, Adapt’s founder and executive director. “Then we’ll measure pre-stim versus post-stim performance.”
Functional rehab centers across the country are integrating e-stim with activity-based therapy to try to jump-start connections between brain and weakened muscles. But like any therapy, the more regularly you do e-stim, the more benefit you’re going to see. Unfortunately, functional rehab usually isn’t covered by insurance. “One of the challenges an organization or facility like us has is that we only see our clients for a few hours a week, and … they need to be doing things outside of our facility in order to keep making the progress they want to make,” says Monteith.
This is the type of problem that PowerDot’s medical platform is aiming to tackle: bridging the gap between the number and frequency of stimulation sessions that would most benefit a user, and the number they can afford — whether in time or money. “We can get them a unit — whether that’s a rental, they purchase it, or we get it reimbursed from a payer network — they can take it home, and we can have a practitioner from Adapt send them a program to do directly to their phone,” says Monteith. “More than just having a person come in for a single session, now we can start to build either a dedicated neuromuscular stim recovery program, or we can start to integrate neuromuscular stim into the broader scope of the recovery project that we’re doing.”
At the same time, PowerDot notifies the provider whenever a client completes a session. “It can be challenging to hold people accountable if you don’t have a measure to know that they’re actually doing these things,” he says. “PowerDot kind of negates both of those challenges by being in touch with the client when they’re not here and seeing whether they’re actually following up on their service.
While data, cost reduction and accountability might not be the most exciting aspects of PowerDot, they’re crucial in advancing the argument that coverage of long-term rehab services is a sound investment for insurance companies. In the battle to make functional recovery more accessible, we can use all the help we can get.
Photos courtesy of Adapt Functional Movement Center.