STIWELL med4 offers unique improvements: The processing of myoelectric signals with four independently adjustable stimulation channels and two measurement channels open up a very broad field of application ranging from neurological indications to incontinence therapy.
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Functional electrotherapy promotes the rehabilitation of motor functions following a stroke or after damages to the central nervous system e.g. incomplete paraplegia. Here, STIWELL med4 can offer unique improvements: The processing of myoelectric signals with four independently adjustable stimulation channels and two measurement channels open up a very broad field of application ranging from neurological indications to incontinence therapy. The multi-channel control also allows the stimulation of complex movement sequences.

The therapy goal, namely to restore lost mobility and autonomy, is accelerated with the use of biofeedback functions. These are based on the ability of the human brain to recreate structures in non-damaged areas that are no longer available in the damaged areas. Of crucial importance during the targeted training is the link of technical movement stimulation and deliberate movement intention.

The latter is recognized as a myoelectric muscle potential of the to-be-trained muscle. Patients receive feedback visually or auditory. Moreover, STIWELL med4 can recognize muscle activities which the patient had adopted as a means to compensate for lost functions yet which hinder the restoration of the original functionality. This feature for excluding compensatory movements during training furthermore contributes to the efficiency of STIWELL med4. Finally, STIWELL med4 is user-friendly and intuitive to operate. For its use at home, patients require only a simple therapeutic introduction.eased.

Four channels for more complex movements

Four individually adjustable stimulation channels allow to regulate even complex movement sequences. For example, the patient can bring the hand toward the mouth and open or close the hand. Likewise, getting up and walking is possible for patients with hemiplegia. In this way, STIWELL med4 is expanding the application possibilities of electric stimulation to an unprecedented scope.

EMG control

Two EMG channels allow for a comprehensive biofeedback therapy during which the neuroplasticity of the brain is used to restore motor control. The possibility to differentiate between compensatory muscle activities and to effect a targeted implementation of EMG-triggered stimulations furthermore contributes to the selective training.

Laptop showing a scene from a biofeedback game on its screen.

Biofeedback Games

Coordination, endurance and strength are directly dependent on the intensity and duration of the training. Biofeedback Games at the PC have proven to be effective motivational tools in this treatment, allowing patients to reach an appropriate training goal over the long term. The games are specially adapted to the requirements of patients with neurological diseases.

Animation graphic of the functional movement using the STIWELL med4 by Otto Bock.

Functional movements

In order to simulate complex functions of an extremity that approximate the corresponding physiological movement patterns, it is usually necessary to activate three or four muscle groups simultaneously or in sequence as a chain of movements. Functional electrical stimulation using the STIWELL med4 can accomplish this. For example, the patient is able to grasp items, position them precisely, and release them. The arms can be extended to provide support. For such motor processes, serial contractions induced by the STIWELL med4 using electric impulses come close to the desired movement patterns. The STIWELL med4 can also be used as an ideal supplement to other forms of physiotherapy treatment that strive to make movement patterns easier or to exercise them.

Animation graphic of the myo-symmetry in the STIWELL med4 by Otto Bock.


When there is no measurable voluntary EMG potential on the affected side, activities can be mirrored using signals from the unaffected side. This results in various positive effects on the affected extremity. In addition to the learning effect, joint movements are also harmonized.

Animation graphic of the EMG inhibitation in the STIWELL med4 by Otto Bock.

EMG inhibition

The innovative characteristics of the STIWELL med4 include the targeted suppression of undesirable activity by antagonistic or compensating muscle groups. Thus the EMG channels provide highly effective training. Stimulation in the target musculature only commences if the trigger threshold is not exceeded in the second EMG channel. Incorrect movements can be suppressed in a targeted manner. Spasticity can also be controlled by precisely monitoring the antagonist. Guaranteed support for voluntary muscle activities and the suppression of side effects is a prerequisite for successful therapy.

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