Spaulding Rehabilitation Hospital
NESS H200 Device Aids Recovery after Stroke

NESS H200 Device Aids Recovery after Stroke

RHCI First in New England to Offer Hand Neuroprosthesis

As seen on CBS4 Boston!
Click to watch the NewsStory

Update:  Good Morning America  May 11, 2009

How it Works
Referrals
Guidelines for Physicians

RHCI has raised the level of neurorehabilitation available in the region by introducing a state-of-the-art device for improving hand function. The device, the NESS H200, promises to improve the lives of those with hand impairment due to stroke, brain injury, and some spinal cord injuries. RHCI has acquired several of the devices and began training staff in June.

RHCI is the only hospital in New England to offer treatment with the NESS H200. The device was developed by Bioness Inc. of Santa Clarita, Calif., innovators in rehabilitation technology.

The H200 consists of a palm-size microprocessor that delivers a mild electrical charge and a soft, polymer prosthesis which fits over the patient's hand and forearm. Electrodes embedded in the prosthesis receive the charge and stimulate muscles in the hand and wrist to perform a sequence of movements. In addition to improving functional use of the hand, the device can reduce or prevent complications associated with central nervous system disorders, including spasticity, disuse muscle atrophy, pain and edema.

The H200 consists of two parts:

  • A palm-size electronic unit that delivers a mild electrical charge. The microprocessor can be programmed by a therapist to guide the patient through a series of exercises customized for each patient.
  • A soft, polymer prosthesis which fits over a patient's hand and forearm. Five electrodes are embedded in the prosthesis. They receive the charges that stimulate the muscles in the hand and wrist to perform a set pattern of movements.

Features of the H200

  • Self-contained unit that delivers a precise amount of electrical stimulation
  • Comfortable to use
  • Can be programmed for the patient to use at home, thereby increasing therapeutic effect

How it Works
Stroke & Brain Injury
After a stroke or brain injury, a person may have paralysis or weakness in an affected arm, leg or side of the body. The person often loses awareness of the impaired limb. One function of the H200 is to encourage the brain to pay attention to the impaired hand and arm so the person can learn to voluntarily move the limb again. Over time, the brain may "rewire" itself so that lost function can be improved.

Spinal Cord Injury
In a spinal cord injury, the connection between the muscles and the brain is broken. The H200 serves as a neuroprosthesis. A prosthesis is a device that replaces the function of a lost or disabled body part. Much as a prosthetic leg allows someone who has lost a limb to walk, the H200 can make an impaired hand reach, grasp, lift or perform other movements.



Inpatient Rehabilitation
RHCI is using the NESS H200 to enhance the return of hand function for inpatients who have just had a stroke or brain injury. Following referral from one of RHCI's attending physicians, inpatient occupational therapists can integrate the H200 into the treatment plan of appropriate patients.

Outpatient Evaluation and Treatment
Outpatient therapists in Sandwich and Orleans are evaluating people with prior neurological injury to see if they are candidates for using the device. For those with the potential to improve, treatment consists of several therapy sessions at RHCI plus training of the patient for a home rehabilitation program. A physician's referral is required for evaluation and treatment. For more information, click here.

Outpatient Evaluation in Sandwich – (508) 833-4141

Outpatient Evaluation in Orleans – (508) 240-7203

Home Therapy Program
Following a series of treatment at RHCI, patients may opt to continue therapy at home. Bioness, Inc. offers a number of options for purchasing or trialing the H200. [At present, most insurances are not covering the cost of purchasing the device. Contact the Bioness Customer Support Department at (800) 211-9136 or info@bionessinc.com for information.] A trained RHCI therapist will periodically assess the patient's progress and program new movements into the device to promote optimum recovery of hand and wrist movement.

To see how the H200 works, please visit www.bionessinc.com

Referrals
A physician's referral is required for an evaluation or treatment with the H200.

For information, appointments, please call:
RHCI in Sandwich at (508) 833-4141
RHCI-Orleans Outpatient Rehabilitation Center at (508) 240-7203.
RHCI in Yarmouth – (508) 771-1300

RHCI Guidelines for Physicians for Use of NESS H200 Neuroprosthesis
For Upper Extremity Treatment

Diagnosis

  • Stroke
  • Cerebral Aneurysm
  • Brain Tumor
  • Traumatic Brain Injury
  • Spinal Cord Injury
  • Other Central Nervous System Disorders

Contraindications

  • Patients with demand-type cardiac pacemaker should not use the NESS H200
  • Stimulation should not be applied directly over the area of a malignant tumor
  • Do not use the NESS H200 over areas of regional disorders, such as a fracture or dislocation, which would be adversely affected by motion from the stimulation
  • Do not use the NESS H200 simultaneously with high-frequency surgical equipment
  • Do not use the NESS H200 in proximity (less than 1 meter) to short wave or microwave therapy equipment

Precautions

  • The safety of using the NESS H200 during pregnancy has not been established
  • Skin problems in areas of contact with the splint may be aggravated by use of the NESS H200

Making the Referral
Patient requires a physician's order to be evaluated/treated with the NESS H200 neuroprosthesis. Please specify treatment with the NESS H200 and indicate functional deficit(s) to be addressed:

  • Improve hand function
  • Increase blood circulation
  • Increase range of motion
  • Joint contracture prevention/treatment
  • Neuro-muscular re-education
  • Pain management
  • Post Botox injections (without Baclofen pump)
  • Prevent disuse atrophy
  • Reduce muscle spasms
  • Tone management

Outpatient Evaluations: (508) 833-4141

NewsStory clip courtesy of CBS4 and cbs4boston.com