CyMedica e-vive: How a Digital, Home-based NMES System Keeps Patients With A Range of Knee Conditions on Track With Recovery

 

Knee osteoarthritis is generally diagnosed and defined as the loss of cartilage in the knee. Typically, the cartilage loss is combined with muscle weakness, which can exacerbate a patient’s pain and stiffness.

If your patients are living with knee osteoarthritis pain, the first course of treatment is exercise and muscle strengthening. This can be challenging for patients with severe pain. The muscle dysfunction, in turn, can actually cause further deterioration within the knee joint.

There is a solution for patients suffering from knee osteoarthritis and muscle weakness. Read on to learn about a home-based therapy solution that allows patients to overcome muscle weakness while providing therapists remote monitoring capability.

The Clinical Challenges of Muscle Weakness

Most physical therapy professionals consider muscle atrophy one of the most prevalent underlying clinical conditions associated with knee osteoarthritis. It is also found in patients recovering from surgical procedures of the knee.

For patients with pre-operative knee osteoarthritis, upper leg muscle strength is reported to be approximately 20–40% lower compared with healthy age-matched controls.¹ Muscle weakness in knee OA is strongly related to a few different symptoms, like those below.

Muscle Weakness Related to OA May Cause

• Poor patient-reported outcomes
• Increased pain
• Activity limitations and falls
• Symptomatic progression of the disease

To combat this weakness, many physical therapists implement different methods of muscle stimulation into patient sessions. Neuromuscular Electrical Stimulation (NMES) offers many benefits to both therapists and patients. NMES is:

• Safe
• Non-invasive
• Drug-free
• A proven modality to treat muscle weakness

Research shows that patients can lose over 60% of their quadriceps strength after knee surgery. In-person physical therapy programs alone may not be successful in restoring critical muscle activation strength.² In addition, disuse atrophy and pain inhibition cause predominant weakness of the fast twitch muscle fibers. In early stages of rehab, NMES therapy is the only clinically useful modality to recruit and activate fast twitch motor units.³

Introducing home-based NMES therapy to your patient care plan helps increase thigh muscle strength and prevent further atrophy caused by knee osteoarthritis or surgical rehabilitation.

How Can Neuromuscular Electrical Stimulation Help?

NMES applies electrical stimuli to a group of muscles. This promotes muscle rehabilitation and strengthening at the same time. NMES uses electrical muscle stimulation (EMS) to cause excitement in the muscle tissue. This is achieved by passing mild electrical impulses from a device through electrodes placed on the skin’s surface over targeted muscles.

The NMES stimulus is designed to mimic the same type of signal the brain sends to the muscle when exercising.

By strengthening the quadriceps, NMES has the ability to correct imbalances and reduce additional stress on the joint. This potentially prevents atrophy and further strength deficits. For patients, this means the difference between getting better and getting weaker.

Empower Patients to Improve their Strength With CyMedica

An option for this type of treatment is the CyMedica e-vive NMES system. It is the only FDA-cleared, app-controlled muscle-strengthening and patient engagement system designed to deliver comfortable, individualized muscle stimulation therapy while connecting patients to their healthcare providers in real-time.

The e-vive system offers a unique, digital muscle strengthening therapy program to help patients treat their knee conditions from home. This also encourages them to get back to an active lifestyle.

The e-vive app communicates to the CyMedica secure cloud-based provider portal in real-time. Here, you have immediate access to your patient’s rehabilitation data. This allows you to motivate and monitor patients in between visits. Sometimes, a little extra support and encouragement goes a long way in keeping people working toward their goals.

Does Clinical Evidence Support e-vive Use?

The e-vive technology is clinically proven to increase quadriceps strength and improve function. At the same time, it provides a platform to improve patient outcomes by remotely collecting data and promoting patient progress. This is a benefit of using electronic monitoring devices and current technology.

For clinical evidence and experience with utilizing e-vive in a post-operative TKA setting, please review the presentation below. The presentation is from Anil Bhave, PT, clinical director of orthopedic rehabilitation, and director of Wasserman Gait Laboratory at Rubin Institute of Orthopedics, Sinai Hospital Baltimore, Maryland.

What are the Remote Patient Monitoring Capabilities?

The CyMedica cloud-based provider portal is a secure platform built to connect you with your patients.

Exclusive data capture technology within the e-vive system collects critical data on patient progress and transmits key points and measurements directly to the portal. The portal gives you real-time, remote access to your patients’ information. It allows you to track patient compliance in:

• NMES therapy
• VAS pain scores
• Activity
• Knee Range of Motion
• Other patient recorded outcomes
• And more

Additionally, the portal groups patients in green/yellow/red categories based on account‐specific metrics for an overview of all patient compliance within the e‐vive system.

Join BetterPT and CyMedica in Providing An Option for At-Home Muscle Stimulation

CyMedica is partnering with BetterPT. This pairing offers patients direct access to home-based muscle strengthening therapy solutions. The platform engages patients and connects providers to actively treat muscles weakened by surgery or knee osteoarthritis.

This collaboration aims to further empower at-home muscle strengthening. It also gives your patients wider access to treatment. At the same time, it increases patient confidence in their journey to rebuild strength.

Click here to learn more about the program and associated costs of implementation.

Discover how to keep your patients in motion when addressing muscle strength decrease, lingering injuries and other mobility challenges.

By joining the BetterPT network, your clinic is also added to the BetterPT clinic location tool roster. This gives patients the ability to find and schedule physical therapy appointments with clinics like yours that are conveniently located. Whether this proximity is to home, school or place of employment, the desired results are the same: quality care that gets people mobile.

To go along with the “at home” method for healing and care, this platform also offers you the ability to implement use of the BetterTelehealth platform. Virtual healthcare is becoming much more popular as it is made readily available – and your patients will love the option.

Make Your Patients Stronger with e-vive

The e-vive system is optimized to help clinicians encourage patients to be more proactive in their rehabilitation.

• Muscle weakness is one of the most common clinical conditions in knee surgical patients and the growing osteoarthritis population.
• Neuromuscular Electrical Stimulation (NMES) is a proven treatment method for correcting muscle weakness.
• Muscle weakness is commonly associated with underlying conditions like diabetes, heart disease, depression, Multiple Sclerosis, and simply aging.

The CyMedica e-vive NMES System is:

• An app-controlled, home-based muscle stimulation therapy
• Drug-free, non-invasive, FDA cleared device
• Clinically proven to strengthen thigh muscles and support joint function⁴
• Uses exclusive data capture technology for remote patient monitoring capabilities

The Cymedica e-vive digital wearable technology is the only FDA cleared, app-controlled muscle strengthening and patient management system uniquely designed to deliver comfortable and individualized muscle stimulation therapy that also remotely connects patients and healthcare providers in real time.

 

Anil Bhave, PT, is the clinical director of Orthopedic Rehabilitation and the Wasserman Gait Laboratory, and Chief of Strategy for Rehab Engineering and Virtual Rehab at Sinai Rehabilitation Center (SRC). Certified in multiple techniques like Astym, dry needling, kinesiological EMG, and blood flow restriction therapy (BFR), Anil’s been practicing for more than 40 years. With a focus on treating patients with limb dysfunction, he is responsible for developing patented bracing and casting techniques.

 

1. Alnahdi AH, Zeni JA, Snyder-Mackler L. Muscle impairments in patients with knee osteoarthritis. Sports Health. 2012;4(4):284-92.
2. Mizner RL, et al. Early quadriceps strength loss after total knee arthroplasty. The contributions of muscle atrophy and failure of voluntary muscle activation. J Bone Joint Surg Am. 2005;87(5):1047–1053
3. Toth MJ, Tourville TW, Voigt TB, et al. Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial. Am J Sports Med. 2020;48(10):2429-2437. doi:10.1177/0363546520933622
4. Klika AK, Yakubek G, Piuzzi N, Calabrese G, Barsoum WK, Higuera CA. Neuromuscular Electrical Stimulation Use after Total Knee Arthroplasty Improves Early Return to Function: A Randomized Trial [published online ahead of print, 2020 Jul 1]. J Knee Surg. 2020;10.1055/s-0040-1713420. doi:10.1055/s-0040-1713420