Chronic Stroke Survivors Maintain Motor Gains with Long-term Use of Vivistim Therapy

The FDA-approved Vivistim® Paired VNS™ System has provided an effective option for individuals with chronic stroke looking to improve arm and hand function. Vivistim Therapy™ involves combining vagus nerve stimulation (VNS) with task-specific upper limb rehabilitation.  A recently published long-term study found that motor gains were maintained for at least three years after starting therapy for individuals with moderate to severe hand and arm impairment.

What is Vivistim Paired VNS Therapy?

The FDA-approved Vivistim® Paired VNS™ System is a first-of-its-kind breakthrough technology that uses VNS during rehabilitation to help improve upper limb function after stroke.

Paired VNS takes advantage of the brain’s ability to change, broadly referred to as neuroplasticity. The simultaneous pairing of exercise with VNS helps strengthen and create new neural pathways, like building a new bridge to bypass the damaged area, to help re-learn motor skills and improve functional movements that became compromised as a result of the stroke.

Vivistim is a medical device that is manufactured by MicroTransponder®, Inc. and is small enough to fit in the palm of your hand. The device is placed under the skin in the upper left chest area along with a lead wire that is wrapped around the vagus nerve in the neck region during a short outpatient procedure.  A few days after the procedure, the patient begins rehabilitation in the clinic as well as at home. The rehabilitation program involves performing a variety of tasks geared towards improving the patient’s functional goals, such as brushing hair, eating, dressing, etc. During each of these functional activities, a therapist will wirelessly deliver a brief, pulse of stimulation to the vagus nerve. Another advantage of this therapy is that it can be done at home. This home-based therapy allows patients to maintain consistent performance of upper limb exercise programs and helps to incorporate their arm and hand when engaging in daily activities.

Vivistim’s Paired VNS therapy is used by ischemic stroke survivors who have chronic arm and hand deficits beyond six months post-stroke. Vivistim users say that the therapy boosted their efforts and helped get back to the daily activities and hobbies that mattered most to them.

Long-term Outcomes: Improved Hand and Arm Function Maintained Through 3 Years

Research supports the long-term effectiveness of Vivistim Therapy over at least three years. The primary objective of the study, published in the Archives of Physical Medicine and Rehabilitation, was to assess whether a long-term home-based intervention was feasible, and whether the benefits of this therapy were maintained beyond one year after starting Vivistim Therapy.

The long-term Vivistim study had participants use their arm and hand in typical daily tasks at home while turning on their VNS device. On average, participants performed the Vivistim Therapy for more than 2 hours per week from 1 to 3 years after the initial therapy. Stroke patients receiving long-term Vivstim Therapy showed significant improvements in their hand and arm function one year after starting the therapy and gained additional functional benefits in years two and three. More importantly, continuing long term rehabilitation with VNS at home after the in-clinic therapy was central to the long-term success of rehabilitation for stroke survivors. Improvements were observed in the ability to move the hand and arm, as well as the ability to use them in everyday tasks.

What Does it Mean for Stroke Survivors?

Using the affected arm and hand during Vivistim Therapy can lead to continued improvements in function for at least 3 years after the start of therapy.

We believe that these results will give you hope that you can regain the ability to perform everyday tasks and hobbies and enhance your quality of life.

Premier comprehensive stroke centers and rehabilitation therapy centers across the country now offer Vivistim Therapy, which can be covered by private insurance or Medicare. Stroke survivors or their caregivers can visit to learn more about the benefits of Paired VNS Therapy and to connect with a clinical specialist to see if they’re a candidate.

I also encourage you to explore our Vivistim Victories and follow us on social media where real Vivistim users share how Paired VNS Therapy helped them overcome challenges in their stroke recovery and regain a sense of independence doing the things they most enjoy.

About Isha Vora, OT, PHD

Isha has been involved with Paired VNS rehabilitation since the VNS-REHAB pivotal trial, where she was a treating therapist. She has given multiple presentations on the implementation of the Paired VNS therapy as well as conducting secondary analyses on the VNS-REHAB pivotal trial data. She completed her masters in occupational therapy from Boston University and earned her Ph.D. in Rehabilitation Sciences from MGH Institute of Health Professions.


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The MicroTransponder® Vivistim® Paired VNS™ System is intended to be used to stimulate the vagus nerve during rehabilitation therapy in order to reduce upper extremity motor deficits and improve motor function in chronic ischemic stroke patients with moderate to severe arm impairment. Do not use if you have had a bilateral or left cervical vagotomy. Risks may include, but are not limited to pain after surgery, hoarseness, bruising, swelling, coughing and throat irritation. While not observed in the Vivistim studies, infection leading to explant is a risk associated with any device surgery. For full safety information, please see Individual results may vary.

©2024 MicroTransponder Inc. All rights reserved.  Vivistim, Vivistim Therapy and Paired VNS are trademarks of MicroTransponder Inc.

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