Anyone tried Accelera SR 100 device? Or Walkasins?

Hi Mike @domiha, I'm not familiar with the Accelera SR 100 (Stochastic Resonance device). I searched Connect and didn't find anyone who has posted about the SR 100. There are quite a few members who have posted about Walkasins. Here is the discussion in case you haven't seen it.
--- Peripheral sensory neuropathy - Anyone tried Walkasins?: https://connect.mayoclinic.org/discussion/peripheral-sensory-neuropathy-device/.

I did find references to the origin of the device that are kind of interesting while you wait for other members who may have some experience to share with the Accelera SR 100. The first one is from the Wyss Institute at Harvard University:
"Accelera’s device, which consists of a set of fully wireless bands that can be worn around the wrist or ankle and an accompanying smartphone app to control output levels, was registered with the FDA as a class 2, exempt device in 2021 . The company has received three separate grants from the Maine Technology Institute for research and development, product design, and clinical evaluation, and in June 2021 was named a winner in the Center for Advancing Innovation’s global 2021 Innovate Children’s Health Challenge. In preparation for its full product launch, Accelera is currently working with physical rehabilitation clinics and hospitals to introduce clinicians to its technology’s benefits. In addition to cerebral palsy, Accelera plans to pursue approval for additional neurological disorders such as neuropathy, essential tremors, balance problems, and supporting proprioception following joint injury."
--- Wearable stochastic resonance technology for supporting neurological function: https://wyss.harvard.edu/technology/wearable-stochastic-resonance-technology-for-supporting-neurological-function/
--- Subsensory stochastic electrical stimulation targeting muscle afferents alters gait control during locomotor adaptations to haptic perturbations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10285629/.

The Accelera SR 100 is an interesting device. Thanks for posting about it.
Its main target is proprioception, per their literature - the ability for the body to know where it is in space. For example, when you see a baseball player in outfield run over and catch a fly ball just by sticking his arm up in the air - and it’s in the exact correct spot. Part of that skill is proprioception- the player, without thinking through the movement, without looking at his hand, knows where his glove is.

Our sensations are damaged with peripheral neuropathy and proprioception is one of them. This device evidently creates and send a signal intended to assist or replace proprioception. How much help this can be for peripheral neuropathy, and at what stage of neuropathy, is a question - probably what they’re working on now.

I’m a retired occupational therapist, proprioception is part of the OT and PT field. My guess, as I am no longer an active practitioner, is that IF the brain can learn to interpret the signal from the Accelera, and IF it’s enough to assist the movement you wish to improve (without touch feeling, and without pressure sensation, just knowing where your foot is in space may not be enough to catch you from falling, or if you’re not getting feedback that the rock you just stepped on is unstable and you need to adjust your stance).
My guess also is that it might take multiple devices at multiple joints to provide enough feedback. We use proprioceptive signals from the hip, knee, ankle, and toe joints to help direct where we wanted our foot to go.

For me, with some minor PN in my toes, the sensation most important to me would be the ability to feel pressure. Without pressure sensation I don’t know how much I need to push off to get the movement I want, I can’t feel the push under my toes.

So back to my unstable rock example, if your foot cannot feel the changes underneath it (the movement in the rock) by using touch and pressure sensation, your proprioception sense still might not keep you from knowing to adjust your stance to prevent a fall. However, we don’t know what the body can learn to adapt to - so I wouldn’t dismiss the idea that the Accelera could be helpful.

But it is definitely an interesting device. Possibly more useful for those that are in the process of losing peripheral sensation because it might be easier to train the nervous system when it is assisting an existing signal, and more difficult once all sensation (signals) are lost.

Sorry, I know my posts go on forever. But one more point. If you’re wanting PT therapy to address your PN using this device - your insurance company needs to know the cost/benefit. How does it save them money if they pay for this therapy. It helps to express your goals in terms that the insurance company understands, $$$. “I want to improve my walking or balance so I can stay independent, or employed? I need balance, use of my hands, walking, to do the essential work tasks required by my employer? I need to preserve, slow, gain peripheral nerve sensation to care for myself, drive, cook, not require assistance? I need improved PN to stay engaged in the community, social, and for quality of life?” When the doctor’s office hands you a short questionnaire, be very specific about your functioning. If you indicate you’re doing pretty good, pretty good doesn’t correlate with insurance companies laying out money. I don’t mean to lie. Obviously you’re there because you’re not 100% okay. Be specific about what’s not functioning correctly.

Thanks for posting this great explanation Tricia @triciaot. I struggled some reading the references I found and your explanation helped a lot!

Thank you for your reply, Tricia! I don't mind long posts at all. And it's great to see one from someone who worked in the field of OT and rehabilitation. As many people as there are who are suffering from PN, and of those the people with balance issues as a result, I was just surprised to stumble across information on the Accelera. Have you ever actually seen the device?
In my case, pain from lumbar stenosis came on suddenly in Sept of 2021. I tried PT, meds, and injections for about a year before having a 4-level laminectomy in Nov of 2022. The horrific pain was gone right away, but that's when I noticed the numbness and tingling in my feet. A skin biopsy showed that I have the beginnings of small fiber neuropathy. An EMG revealed there is still some foraminal compression in my lower back, and I feel that is contributing to the nerve issues in my feet.... and thus the balance issues and wobbly gait.
So I suppose that I may be one of "those that are in the process of losing peripheral sensation because it might be easier to train the nervous system when it is assisting an existing signal, and more difficult once all sensation (signals) are lost."
As for insurance, I know of no local doctor or PT who would even be interested in the Accelera. So IF I were to try it, I would have to pay out of pocket. If I knew it would help me, I would buy two of the devices, one for each ankle/leg.
On another subject, are you familiar with red light therapy devices? And if so, what are your thoughts? From what I can tell, there are "medical quality machines/devices" that may be more helpful and efficient than some of the less expensive devices that are sold online.
If I may ask, Tricia, what treatments are you using to try and help your neuropathy? Supplements? Shoes? Devices? Meds? I'm taking R-ALA, Benfotiamine and my podiatrist prescribed MetanX for me. Gabapentin and Lyrica each did nothing for me... and made me feel loopy and helped me gain weight. Fortunately, I don't have a lot of pain issues.... just primarily the numbness, tingling, and sometimes burning.
Thank you so much for sharing anything based on your experience as an OT.
Best wishes!
Mike

Well. Ha. Just lost about three paragraphs of an answer to you! Switching back and forth between open sites to do research. Cleared up a few open links - including what I’d just written. I’ll recreate it tomorrow.

A few things -
Have you looked at a peripheral nerve chart and dermatomes? One will show what muscle function is associated with the nerve, for instance if your laminectomy was at the S2 nerve level it would involve plantar foot flexion (pushing foot down - toe pointing down) and foot eversion (foot roll to the outside, pressure is on a flatten arch and big toe side). The chart shows what movement and body part each nerve activates.
https://www.orthobullets.com/spine/2002/lower-extremity-spine-and-neuro-exam

The dermatomes shows the connection between the nerves and the area of skin sensation. S2 affects a strip all the way down the back of the leg, under the heel, and a small area into the arch.
https://en.wikipedia.org/wiki/Dermatome_%28anatomy%29

The dermatomes may show where the sensory damage is in small fiber neuropathy. The forminal compression may affect the nerve function as seen on the chart that indicates muscle movement. You might be able to back track - go fromwhere your pain is, or where your foot wobbles, and follow that up into the spinal nerve level.

Will post more tomorrow and try to answer your questions in chunks.

Full disclosure - I worked in the pediatric OT area in the K12 schools. I am happy to help explain, find research, access OT resources I might have, and give an educated opinion. But I was not a rehab therapist, although I was trained in rehab, brain anatomy and physiology, and neurology. My last 12 years of work was in the OT assistive technology area. I retired in 2019, but keep my license up to date.

Red light therapy for nerve regeneration or pain? I can’t find any research with a good solid answer. Conclusions say they “propose” or “suggest” it might work.
Mayo Clinic has info about red light therapy and seasonal affective disorder only.
Cleveland Clinic, another of my go to sites for researched answers, has a lot to say, but not that it helps the nerves.
https://my.clevelandclinic.org/health/articles/22114-red-light-therapy

A few years ago I was looking into a near-infrared light therapy sauna but never followed through and purchased one. They have a lot of research links on the science that might be helpful to look through - here's a link to their references on regeneration that seems to be mostly on wound care/healing - https://sauna.space/blogs/infrared-sauna-light-therapy-research#topic28.

Google Scholar is another search tool that I like to use for finding medical research. What's great about it is the capability to sort the results and find the newest info. Here's what it shows for mitochondria +red light therapy: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C24&q=mitochondria+%2Bred+light+therapy&btnG=

Hi, Tricia. Sorry to take so long for a reply. Yes, I have looked at a chart. I had an EMG done a few months ago, a year after my laminectomy, and the results showed some remaining radiculopathy at levels L4, L5, S1. I have NO disc left between L5 and S1. No indications of myopathy. So I'm thinking that the numbness in my feet may be due to the remaining compression "outside" the spinal column... perhaps where the nerves pass through the foramen.

I had a bilateral steroid injection at L4/L5 about a month ago and that seems to have helped somewhat. I will repeat the process in April. I'm hoping if the steroid calms the nerves down a bit, that residual effect may stay in place for awhile. Fingers crossed. My surgeon has suggested that a fusion of L4/5 and S1 could clear up the neuropathy in my feet, but I have no guarantees.

Before the laminectomy, I could barely walk because of pain in back, hips, legs. After the procedure L2-S1 I am able to walk, but the neuropathy creates a problem with balance. I try and walk 10k steps several days per week, and that helps. The Walkasins seem to have a bit more research behind them, but they are much more expensive than the other device, which is much less.

I thank you for taking the time to reply to my post and share your knowledge!!

Best wishes! Mike

I was thinking for nerve regeneration, but that may not be the case. I have numbness and tingling in my feet. Very occasionally, I have a bit of burning. But I don't have a lot of real pain that some people describe.

Thanks for the link to Cleveland Clinic. One more source of info!!

Best wishes!
Mike

Here are some things to consider, maybe discuss with your doctor if you’re talking about more surgery or different treatment -
And, I can’t stress enough, I didn’t work in rehab but have enough understanding that focuses the searches I do. I might have good questions, but not answers.

Nerves are so complex, that I may be over simplifying this info. Small fiber PN, causing the tingling, numbness, and some burning, is from sensory nerves located near the surface of the skin. It is not damage to the nerve pathway that carries deep pain and pressure.
There was a study about post-decompressive neuropathy including a case study somewhat similar to you, look near end of article.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284122/

This study does say that this type of neuropathy can resolve itself, although the case study had steroid injections 3 months apart.

A question that I would want clarified for myself from the doctor - is whether the nerve damage is coming from the area near your stenosis/laminectomy, that is central-to-peripheral, . . . or is there damage to the nerves that is happening near your lower limbs and moving upward, peripheral-to-central. Peripheral-to-central is typical of diabetic neuropathy, Epstein-Barr, ALS.
It would make a difference in the type supports you’re considering, Accelera, and Walkasins,
My guess is that Accelera is intended to help preserve nerve transmission in systemic type nerve issues (diabetes, Epstein-Barr, ALS). It may not help nerve damage that originates in a central area - and possibly could irritate nerves that are trying to repair themselves.
(Notice I say, guess, and possibly a lot - I have questions not answers).
The Walkisins state they send sensation back up the pathway to be interpreted as foot movement. Looks like it sends a signal when there is heel pressure, and when there is toe push-off. Forward movement. But whether the signal that is sent through a band on the lower leg is being sent through the sensory nerve pathway, and possibly more difficult for the brain to interpret? Walking involves deep pressure.
The Walkisins band must also reach up above the area of tingling and numbness - it has to send signals through working nerves, not damaged ones.

I damaged my L5 nerve about 35 years ago. Ortho surgeon said I had pinched the nerve as it ran near the hip joint. I actually jammed that hip/leg while run/walking over rocky boulder field at night trying to keep up with middle schoolers at a church camp.
Resulting damage: I could not push down well with that foot, lost the ability to lift my big toe, and had excruciating pain in the calf of my leg on that side. Pain relievers, anti-inflammatories, and time. By 6 months the pain was gone, with some residual toe lift problems - stumbling on slightly raised surfaces that caught my toe. I don’t notice a problem now except when I’m extremely tired. If I have leg cramps, or foot tingling (not often, and maybe calcium/potassium/dehydration related) but it’s always on that side, or worse on that side.
One thing I did that temporarily relieved the excruciating pain, was to position myself so that there was no pressure on the L5 nerve near the area where the damage was. That meant, I would lay face down across the bed, with my hip just slightly supported on the edge, and my legs hanging toward the floor. If I put much pressure on my feet/legs it sent jolts of pain. I had very little pain when my hip joint was not being compressed - the joint was pulled apart a bit by hanging across the edge. I mention this because you (although you’ve said your pain had diminished) or others reading this post might be interested in trying to find a position, even if it looks weird, to reduce the pressure in the area where the nerve is being compressed.

More on what I take for current PN, next post.