Articles

Waveform matters: what new evidence tells us about transcutaneous spinal cord stimulation

Transcutaneous spinal cord stimulation (tSCS) has moved quickly from a research curiosity to a recognised tool in neurological rehabilitation. People living with spinal cord injury, stroke, and multiple sclerosis are asking us about it. Clinicians want to know which device to recommend. Equipment commissioners want evidence-led guidance before authorising spend that can run into tens of thousands of pounds per system.

A paper published in Nature Biomedical Engineering on 12 May 2026 has added something important to that conversation. It is not a clinical trial. It is a careful study of the physics and physiology that govern which nerve fibres a tSCS device actually recruits. The finding is consequential, and it bears directly on the choice of device.

In short: the waveform you choose determines whether tSCS does the thing rehabilitation needs it to do.

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PRAFO, Pressure Ulcers Derek Jones PRAFO, Pressure Ulcers Derek Jones

Floating Heels: What the 2025 International Pressure Injury Guideline Means for the PRAFO

Heel pressure injuries are one of those problems where the evidence has been ahead of everyday practice for years. We have known for many years that pillows and improvised supports rarely keep a heel clear of the bed for long, and that a heel touching anything is a heel under pressure and shear. The 2025 International Pressure Injury Guideline (the fourth edition produced by NPIAP, EPUAP, and PPPIA) has now caught up to that reality, and in doing so it has changed the language clinicians and commissioners should use when they think about heel protection.

The guideline introduces a phrase worth noticing: "floating heels."

It is not a marketing line. It is a clinical description of what an effective heel offloading intervention has to achieve, taken from the guideline itself. And it has practical implications for any service that has to choose, fund, or audit heel protection equipment.

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Denervation, RISE Stimulator, NMES Derek Jones Denervation, RISE Stimulator, NMES Derek Jones

Normal vs Denervated Muscle: Why the Rules of Electrical Stimulation Change After Nerve Injury

It is quite common for us to meet clients who have tried electrical stimulation on a limb and found that nothing happened. No matter how high the intensity was set, the muscle simply would not contract. They arrive frustrated, sometimes having been told that nothing more can be done. When we then use the RISE Stimulator, a specialist device capable of producing the long-impulse-duration waveforms that denervated muscle actually requires, they are often surprised and relieved to see a contraction for the first time.

That moment of surprise reveals an important gap in understanding. The muscle did not fail to respond because it was beyond help. It failed because the wrong electrical 'language' was being spoken. A denervated muscle is not simply a weak muscle. It is, in a very real sense, a different tissue with altered structure, electrical properties, and activation rules. Understanding these differences is the foundation for making sense of any treatment approach.

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Pressure Ulcers, PRAFO Derek Jones Pressure Ulcers, PRAFO Derek Jones

ICU Heel Protection: Starting Prevention Early

Intensive care patients face the highest pressure ulcer prevalence of any hospital setting—14.32% according to international prevalence surveys. The heels account for a substantial proportion of these injuries. And unlike many ICU complications, heel pressure ulcers are largely preventable with appropriate intervention.

Yet in the complex, high-acuity environment of intensive care, heel protection can be overlooked. The focus—rightly—is on keeping the patient alive. Organ support, haemodynamic stability, ventilation, sedation. Heel protection rarely tops the priority list. But if a heel pressure ulcer occurs then this complicates continuity of care.

This article makes the case for implementing prophylactic heel offloading as a standard component of ICU care, and examines what effective implementation looks like in practice.

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Stim2Go's Body-Aware Technology is Changing Therapy

Rehabilitation technology is undergoing a revolutionary transformation, driven by innovative solutions that prioritise adaptability and personalised care. This article explores how cutting-edge advancements, like Stim2Go, redefine therapy by aligning with the natural dynamics of the human body. By shifting from traditional, one-size-fits-all methods to highly individualised approaches, we are entering a new era of recovery that holds profound implications for patients and clinicians alike.

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FES Cycling Revisited

n this article, we showcase the arrival of a new product called Stim2Go, which promises to open up the availability of Functional Electrical Stimulation (FES) Cycling to a much wider group (and do some other clever things, too).

PAJUNK GmbH, one of the global market leaders in regional anaesthesia, has introduced the Stim2Go worldwide. The product' was developed and operated by another German company, SensorStim Neurotechnology GmbH. The product has regulatory approval in the USA and is now available in Europe and the UK as a registered medical device.

The introduction of Stim2Go provides a more accessible and efficient solution for (FES) cycling because it allows the user to add this capability to just about any passive/active bike such as the Thera Trainer range.

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