Summary of replies - WalkAide vs NESS L300

Posted By: Tim on September 8, 2008

Dear colleagues,

Thanks for your replies to my recent request for information on Walk Aide vs
Bioness FES foot drop systems. Please find a summary of replies posted
below.

Cheers,

Tim Jarrott
CPO - Australia

RESPONSE 1

· The WalkAide System does not require use of a heel sensor. Individuals
are free to choose their footwear, or to wear none depending on their safety
and the judgment of the medical professional working with them. Because no
heel sensor is used, there is no concern regarding inconsistency of
triggering the sensor, for example if the sensor moves in the shoe, if the
individual takes a step that doesn’t contact the sensor as with ambulating
up stairs or on uneven surfaces, or if the sensor wears out. With heel
sensor technology there may also be discrepancies in how much pressure is
detected depending on shoe type (sneaker vs. dress shoe) as well as the
surface a patient is ambulating on.
· The WalkAide System uses a patented tilt accelerometer to read the angle
of motion of the tibia and the velocity of motion. It alone triggers the
stimulation and turns it off at the appropriate times during the gait cycle.
No heel switch is needed and the device works consistently on level
surfaces, uneven surfaces, stairs and for variable walking speeds.
· The WalkAide System uses only 1 AA battery for power. A single AA battery
that can be bought in almost any store will power the WalkAide for
approximately 30 full days of use. There are not 3 batteries. There are no
batteries that need recharging. The device will not fail if multiple
batteries aren’t all charged, as there is only 1 replaceable battery and an
indicator light that alerts the user 2 days in advance, that the battery
needs changing. The Bioness system uses 2 rechargeable batteries and one
other battery for its 3 components.
· The WalkAide System is self contained. There are no other parts; no heel
sensor and no remote control to be worn via hip pack or lanyard. A single
cuff is worn below the kne with the WalkAide. With the Bioness system you
will have 3 components. A cuff worn just below the knee, a heel sensor and
a control mechanism worn on a lanyard or carried in the patient’s pocket.
· The WalkAide System uses blue tooth technology to transmit data between
the computer software and the device. The blue tooth connection is made
during programming and is disconnected when the programming is completed.
Once the program is in the device, customized for the patient, it cannot be
disrupted. In a situation where Wi-Fi radio frequency is used to
communicate between multiple components, there is a possibility of
transmission being disrupted due to outside interference or if the
components are not all with the individual at all times.
· The WalkAide System uses high tech software that is easily installed on
most laptops and PCs. It is simple to use by a trained clinician and
allows the clinician to adjust multiple parameters for customization of the
WalkAide for each patient. It allows for data collection via 3 sources
during a gait analysis and then optimizes the data to appropriately time the
stimulation during normal walking. Because of the blue tooth technology,
the computer need not be in the same room as the patient. Data can be
transmitted for approximately the length of a football field.
· The WalkAide is FDA approved and has published research to back up its
claims of efficacy. No other similar device on the market today has such
research. The WalkAide was FDA approved in October, 2005 and has been
available in the US for just under a year. The tilt sensor technology used
in the WalkAide has been proven for over a decade through research and
development in Canada.
· The WalkAide System is FDA approved and therefore only trained clinicians
can use it for their patients. Training for therapists is provided when a
Clinician Kit is purchased for clinical use. Training will be provided for
as many therapists as the facility has who wish to become WalkAide trained
clinicians. There is no additional cost for training. The training will be
done in the facility, conveniently for the clinicians. Follow up support
with patients will be available long term and is expected with the initial
patients seen. You will have both local support and corporate support for
patient and technology issues.
· The WalkAide is a great tool for gait training, neuromuscular reeducation,
building confident, safe and independent function, etc. Innovative
Neurotronics, Inc. wants clinicians and patients at all stages of rehab,
acute, sub acute and chronic, to have access to this amazing technology.
That is why a special discounted price is being offered to interested
clinicians. The price of a Clinician Kit, including the material items
needed for patient care, the software, the blue tooth technology, the
training and the follow up support is only $2950. This kit is valued at
$6493.99, not including the man power for training and support.

What are the Bioness reps saying???

The Walkaide does not have the ability to detect changes in walking speed
with patients because it uses the tilt sensor for programming purposes.
Response: This is not true. The WalkAide uses patented accelerometer
technology which measures both the angle of the tibia during swing phase as
well as velocity. This enables the Walkaide to take into account both a
variety of walking surfaces, inclines and walking speeds. The Walkaide will
also allow proper gait mechanics for stair climbing.

Patients get a number of aberrant stims when the tilt sensor is triggered
inadvertently.
Response: The device can be programmed to accommodate the sensitivity
necessary for each patient. With a device like the Bioness you can
inadvertently cause a stim just be lifting your heel off of the ground (for
example, if in sitting and you lift up your leg).

The L300 allows users to change parameters “on the fly”.
Response: WalkAide users are also able to quickly change the intensity of
the stim they are receiving. From a safety perspective it is not in the
patient’s best interest to be able to change any of the other parameters as
they may set themselves up for an unsafe walking environment. The reality
is that they are touting the use of their remote control to change
things…how often in real life does a patient need to be able to do this?

The L300 uses an accelerometer as well.
Response: I don’t believe this is true because WalkAide has a patent on
the accelerometer that is good for years to come.

The L300 uses the newest technology available.
Response: The use of a heel sensor to trigger a dorsiflexion response has
been around since the 1960s. The only thing that is new is that the heel
sensor sends information wirelessly as opposed to being wired to the piece
at the knee. One other thing to keep in mind is that there have been no
long term studies to validate the sensitivity and consistency of the heel
sensor over time. Will the sensor become more/less sensitive? Responses
are bound to be different just by walking on hardwood versus a rug. They
are also going to be different depending on the type shoe worn (softer
sneaker vs. harder dress shoe).

RESPONSE 2

I work for Hanger and obviously we do walkaide systems. We have had two
patients that had both and both paitents stopped using the bioness and only
use the walkaide.
The cuffs are similar, but the bioness requires the shoe attachment which
can be an issue if your patients want to walk barefoot.

RESPONSE 3

I have about a dozen patients wearing the Walkaide System, and they are all
doing very well. The only limitation I have found is if the patient has poor
ROM or takes short, uneven steps. The Walkaide functions by using a tilt
sensor, so if the pt doesn't create enough motion with their stride, it
won't function properly.

There is a foot sensor that can be plugged into the Walkaide that measures
heel pressure and uses the pressure change to trigger the stimulation, but
it is a wired sensor.

The Ness unit uses a wireless foot pressure sensor to trigger stim. This
makes it a more appropriate choice if a patient cannot utilize the tilt
sensor on a Walkaide.

In my opinion the Walkaide should be considered for every candidate.

If their functional level is too low to allow them to use a FES unit with a
tilt sensor, theys hould be consideredf or the Ness unit.

RESPONSE 4

I have done 12 WalkAides now and am very pleased. My analysis was simplified
by Bioness not responding to numerous emails and calls over a four month
period. When I finally did get someone to talk to me and they found out I
was a CO and not a PT they got rude and cut the conversation short. That
was the final straw.
Initially the fact that Walkaide can be used without a shoe intrigued me.
theBioness has to have a manner to keep the sensor under the heel.
No Therapists are interested in bioness here due to the course cost and all
the upfront expenditure. While Walkaide does not work for everybody the
people I have delivered to Swear by it. I have repeatedly asked Walkaide for
a smaller version to fit my pediatric Population or to at leat make the
intensity knob with settable limits in the softwear but to no avail. I
suppose they may have paid so much for the idea that they have to recoup
cost at this point. The biggest problem I see at this time is the cost of
these type of devices.I have fit 12, Qualified 34 and evaluated 49 patients.
The eight appts reccommended break down as 5 training and 3 follow up as
best as I can tell.

RESPONSE 5

We haven't fit either one. I' ve heard that the Walk aide has difficulty
with side stepping. We were consideringthe Bioness until we had the Rep
come in and learned of the financial investment for our facility and the
investment a therapist from the area would have to make. We have opted at
this point to work with Wearable Therapy.

RESPONSE 6

I use the WalkAide here in our office. We looked into both FES before going
with the WalkAide a few pros and cons for both.
Bioness
1. Patient has to wear shoes so that heel sensor can be contacted by
heel.
2. Unit, blue tooth heel unit, and the remote for the blue tooth have
to be charged each night.
3. The patient has to carry a remote for the device.
4. The clinician set up or trial kits are side specific. Meaning that
you have to purchase a unit for the right side and the left side.
5. The clinicians set up or trial kits cost the same as the patient
kits. $5900.00 each
6. L300 has multiple items that need to be replaced each couple years
that are not told at initial contact. See below for both devices.
7. Cost of battery replacements suggested every 2 years at
approximately $65.00 for each of the three units.
8. The L300 is a lot more pleasant cosmetically.
9. Do to device being triggered by heel switch easier to set up.

WalkAide
1. Do to patented tilt switch no pressure switches needed therefore
no shoes required.
2. Runs off of a single standard AA battery. So if battery is running
low patient can go in a store and get a new one.
3. Unit can be used on either leg. Unit is not side specific. That
also means on one clinician kit needed instead of two.
4. Consistent placement of cuff and electrodes make results very.
Patience will be a virtue with this unit on some patients.
5. Electrode costs for a year are similar.
6. Not so cosmetically appealing.
7. Battery life about 1 to 1 ½ month(s).
With either unit there are certain things that can affect success. I have a
patient that has had good success, but wore the WalkAide unit for 18 hours,
and developed a reaction and rash from it. The patient did have the unit for
about 3 months and was wearing it about 10-12 hours a day.
Placement of the electrodes and patient being able to duplicate is really
crucial. Below are listed the replacement schedules recommended by both
manufactures. Hope this helps.

1 year supply of electrodes for WalkAide FES device $250.00
WalkAide electrode lead cable replacement every year $40.00
12 AA batteries 1 year supply $16.00
Cuff replacement each year $200.00
WalkAide device itself following Medicare guidelines for
replacement every 5 years and to keep abreast of new technology and
upgrades $4500.00

1 year supply of electrodes for Bioness FES L300 device $288.00
Battery charger replacement every 3 years as suggested by manufacturer
$130.00
Battery tester replacement every 2 years as suggested by
manufacturer $250.00
Battery replacement every 2 years as suggested by manufacturer $
65.00
Strap and case for FES replacement every year $ 200.00
Electrode Base for electrodes replaced every 2 years as
suggested by manufacturer $70.00
Bioness H200 hand FES device itself following Medicare guidelines for
replacement every 5 years and to keep breast of new technology and upgrades
$ 5900.00

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