Bioness^®, Inc. NESS^® H200™

When a person suffers from a stroke, brain injury or spinal cord injury, partial or complete loss of forearm and hand functional control, such as the ability to grasp, can dramatically impact their quality of life.  Northeast Rehab is excited to offer a new treatment modality, the NESS ® H200™, made by Bioness^®, Inc. This device has a remarkable impact on the patient's control of their impaired forearm and hand when used in combination with a functionally based rehabilitation program.

Northeast Rehabilitation Hospital is currently the only facility in New Hampshire and one of a hand full of facilities in New England, where the NESS H200 is used in both acute and outpatient rehab programs.  With the introduction of the NESS H200 Northeast Rehabilitation Hospital continues to demonstrate its commitment to offering the best available rehabilitation technologies and further differentiates the intensity and focus of care of our inpatient neuro-rehab services from those offered by skilled nursing facilities.

The NESS H200 fits over the patient's hand and forearm to position the device over key muscle groups for effective stimulation through external electrodes.  A remote microprocessor can be programmed by a therapist to allow the patient to perform a customized program of hand movements.  For some patients, the NESS H200 will improve the functional control of the impaired hand.  For other patients, use of the NESS H200 along with neuromuscular re-education and rehabilitation often results in improved volitional hand function.  Functional gains made in the clinic with the NESS H200 can continue to be made at home through a device rental or purchase program offered by Bioness, Inc.

Patient outcomes at Northeast Rehabilitation Hospital indicate this treatment device holds great promise in improving upper extremity function in appropriate patients.

Treatment with the NESS H200 can begin as soon as the patient is medically stable.  Ideally treatment should begin during the acute rehabilitation admission, where the H200 can be part of the patient's multi-disciplinary program.  Appropriate patients may also continue with a "therapy directed" home program utilizing the H200.  Patients with previous central nervous system injuries (1 year old or older) with arm and hand disabilities may benefit from this treatment in the outpatient setting.

Clinical outcomes from H200 treatment are affected by many factors including:

• Severity of the primary injury,

• Time since the stroke,

• Co-morbidities,

• Pre-existing conditions,

• Patient comprehension, and

• Overall cognition

Treatment goals may vary and are very dependent on whether the objective is to manage impairment or improve functional outcomes.  Patients with chronic disabilities may use the NESS H200 for the rest of their lives to manage impairment. Patients who begin the NESS H200 use in the acute rehabilitation setting will continue use as long as improvements are made.  Depending on the extent of the central nervous system damage they can be expected to continue use of the H200 to manage their impairment.

Not every stroke, head injury or spinal cord injured patient is appropriate to the NESS H200.  Our team of therapists are specially trained in patient assessment and selection for device use and treatment.  Some of the general circumstances that might rule out NESS H200 use include:

• Patients with demand type cardiac pacemakers and other implanted electrical devices (ICD, insulin pumps, baclofen pumps, etc),

• Treatment areas containing a malignant tumor,

• Use over regional disorders such as fractures, traumatic dislocations which would be adversely effected by motion from stimulation,

• Simultaneous use with high-frequency surgical equipment,

• Use within one meter of short wave or microwave equipment,

• Use during pregnancy has not been fully established, and

• Use over areas with actively broken, blistered, infected or irritated skin.

        Note:  Use with patients with implantable cardiac defibrillators need specific physician clearance.

While treatment with the NESS H200 is now an integral part of the acute inpatient rehabilitation program at Northeast Rehab, it is also available on an outpatient basis with a physician's referral.  To make an outpatient appointment for the NESS H200 please contact our outpatient therapy scheduling department at (603) 681-3216.  For more information on the NESS H200 or to schedule a presentation please contact Dianna Gleeson, Clinical Specialist at (603) 681-3222 or by email at dgleeson@northeastrehab.com.