Harnessing the Power of Neuroplasticity to Restore Function

How the Neubie & Neufit Method

Can Help Multiple Sclerosis

Welcome Letter from Garrett Salpeter

FOUNDATIONAL NEUROLOGICAL CONCEPTS

How does the Nervous System Work?

Somatosensory System Function

How can the Neufit Method Impact the Nervous System?

How does this Pertain to Multiple Sclerosis?

Neuroplasticity

The Neubie & Autonomic Nervous System

Welcome Letter from Garrett Salpeter

NeuFit is born out of a belief in the power that exists within all of us humans – the power to heal, adapt, overcome challenges, and grow as a result. In many experiences, we see the healthcare industry taking that power away. They tell us we need to rely on a pill, surgery, or supplement, but they never tell us how to activate our own internal power. We are here to change that dynamic.

When trying to affect change in the body, the nervous system is a great place to start. The nervous system controls virtually everything about us, including functions as diverse as pain signaling, muscle strength and weakness, balance, flexibility, sleep, digestion, waste elimination, blood pressure, anxiety, and more. Because of these broad effects, working neurologically provides a bridge to affect positive, far-reaching change in your life.

In this e-book, we will dive into the nervous system and how it functions. And we will share what we believe to be some of the most powerful tools to affect its function.

Yours in health and high performance,

Garrett Salpeter Founder and CEO, NeuFit

NOTE:

The NEUBIE is FDA CLEARED for the following uses:

1. Maintaining or increasing range of motion

2. Increasing local blood circulation

3. Neuromuscular Re-education

4. Preventing atrophy

5. Reducing Spasms

6. Preventing venous thrombosis after surgery

7. Management or relief of chronic pain

8. Management of post-surgical and post-traumatic acute pain

CONTRAINDICATIONS for use of the Neubie include:

1. Pregnancy

2. Cardiac Pacemaker

PRECAUTIONS for use of the Neubie include:

1. Active or recent blood clots

2. Active or recent cancer

FOUNDATIONAL NEUROLOGICAL CONCEPTS

In order to understand how we can most effectively influence the nervous system, it helps to have a model to understand how the nervous system works. We use the concept of a feedback loop to describe the function of the nervous system.

This four step model shows us the possible places where we can influence nervous system function. Ultimately, we wish to improve the speed, accuracy, and overall bandwidth at all four stages. And, as you will see, by focusing on one in particular we are able to get the greatest impact.

How Does the Nervous System Work?

INTEGRATION IN BRAIN

THE NERVOUS SYSTEM FUNCTIONS AS A BIG LOOP:

1. Receive inputs from internal and external environment.

2. Transmit inputs to the Central Nervous System

3. Process, integrate, and decide how to act on those inputs

4. Send an output to the muscle, organ, or wherever the action will take place

Somatosensory System Function and Threat

The Somatic Nervous System is one part of the nervous system that “senses” the inputs that begin the feedback loop.

“Somato” - means body

“Sensory” - the process of gathering information through detection of a stimulus

It controls our perception of touch, pressure, pain, temperature, position, vibration, and movement. When the body and nervous system is working normally, it perceives these input signals sent from the somatosensory system clearly, and in turn results in normal outputs (in this case, movement). However, when the body is feeling threatened (pain, injury, etc), there is poor perception in the somatosensory system of these input signals, resulting in poor movement. The NeuFit Method helps to improve perception, in essence decreasing perceived threat, and improving movement.

Poor Perception Improved Perception CLEAR SIGNAL UNCLEAR SIGNAL

Increased Threat Decreased Threat

Poor Movement Improved Movement

How Can The NeuFit Method Impact the Nervous System?

ALMOST ALL FITNESS AND REHABILITATION SYSTEMS ARE OUTPUT-BASED

• If asymmetrical, “Move more to that side”

• If limited mobility, “Stay in position to increase flexibility”

• If weak, “Try harder!”

NEUFIT IS INPUT-BASED

• Change the inputs, and the outputs can change

• Find the right inputs, and the outputs immediately improve

INPUTS

5 Special Senses

Proprioception

Thermo-receptors

Chemo-receptors

Baro-receptors

Mechano-receptors

(Muscle Spindle/ Golgi Tendon Organ)

NEUFIT METHOD INPUTS

Manual Therapy/Targeted Activation

Strategic Movement & Mobilization

The Neubie

OUTPUTS

Contract-Relax

Range of Motion

Strength Speed Pain

Heart Rate

Blood Pressure

Hormones

The Neufit Method is an Input-Based Approach to Treatment, rehabilitation, and training. It involves both manual stimulation and electrical input based stimulation of the nervous system using the Neubie. The diagram above summarizes the Nervous System Inputs and Outputs in the context of rehabilitative/training practice.

How Does this Pertain to Multiple Sclerosis?

Restoring Lost Function

Is it possible? How?

If there is damage to the nervous system, we either need to:

1. Repair the damage = structural remodeling

• This could be remyelination

• Quality of movements - performing the same movement with good quality over and over to repair the damaged pathway to your brain

Evidence for Structural Remodeling

Re-myelination

• Thinner sheath, but still effective

• Mediated by numerous chemical, cellular, and genetic mechanisms

2. Compensate for the damage = functional reorganization

• This could be substituting other brain areas and creating new pathways

• Using higher brain areas to perform certain functions that would have been performed by other, lower, or more specific brain areas. The activity is distributed, using areas that would otherwise be reserved for novel or more complex tasks -- so it gets done, but takes up more “bandwidth” than would be required for someone who does not have MS.

Evidence

for Functional reorganization

• “Neurons that fire together, wire together”

• This describes how we build habits and patterns, which could be good or bad

• If we create habits/patterns of good form, quality movements, etc - then we will continue to grow these patterns.

• If we create habits of not using certain muscles/pathways, then those muscles and pathways will not be used in our functional life.

How Does this Pertain to Multiple Sclerosis? (Continued)

EVIDENCE FOR FUNCTIONAL REORGANIZATION (CONTINUED)

Depending on what movements, patterns, etc you are doing, neuroplastic changes can be GOOD or BAD.

We always adapt to exactly what we’re doing.

Learned disuse:

• A significant contributor to disability

• Example of neuroplasticity that is maladaptive Repair and Compensation are examples of Neuroplasticity

What is Neuroplasticity?

Neuroplasticity refers to the brain’s remarkable ability to adapt and reorganize itself in response to environmental signals. This is achieved through the process of remodeling the nervous system, allowing the brain to change its structure and function to suit the demands of its surroundings.

How Do We “Tap Into” Neuroplasticity?

There are a few requirements or prerequisites for triggering neuroplasticity to work in a positive direction.

1. Amount of Work

• Neuroplasticity does not happen overnight.

• A perfect example is the requirements for olympians or professionals to “master their art” by training consistently for years.

• It takes hundreds of thousands of repetitions of the same movements for these athletes to become successful in their sports.

2.

Specificity of Work

• Therapy sessions require quality movements that are targeted at the exact adaptions being pursued.

• It is extremely important to perform the same movement, the same way each time for neuroplastic changes to occur. This allows the brain to get the point that this movement is important and that it is worth it to invest the resources to build and maintain those particular muscles and neurological pathways.

3. Support

• The body must have the raw materials, i.e. nutrition, to rebuild the nervous system.

• It is important to reduce inflammation to minimize further damage and allow the body to make consistent progress without reverting

• Sleep is another vital piece, as sleep is when the rebuilding and remodeling actually takes place.

What is Neuroplasticity? (Continued)

4. Caveats that Impact Neuroplasticity

• Age - Neuroplasticity is more difficult to achieve the older we get. But, it’s still possible!

• Degree and location of damage

– Though neuroplasticity is possible for everyone, the degree and location (within the Central Nervous System) of the damage will impact neuroplasticity.

– Degree of damage:

- Contrast enhancing lesions - represents an area of inflammation in the brain

– Citation: https://www.researchgate.net/figure/T1-black-holes-in-multiple-sclerosis-Axial-T1weighted-image-shows-multiple-hypointense_fig5_331774458

– “Black Holes” - represent a small amount of brain damage. Correlate more with long-term disability so that they will impact neuroplasticity more than inflammatory lesions.

– Citation: https://www.researchgate.net/figure/T1-black-holes-in-multiple-sclerosis-Axial-T1weighted-image-shows-multiple-hypointense_fig5_331774458

What is Neuroplasticity? (Continued)

– Brain Atrophy

- The amount of brain atrophy can impact neuroplasticity.

– Citation: https://www.sciencedirect.com/science/article/abs/pii/S1474442206703490

• Location Examples:

– Spinal cord lesions are usually more influential on mobility than brain lesions – Left side of the brain will impact speech, but the right side usually does not

5. Health (e.g., Wahls Protocol)

• Not only does your quality and amount of movements matter when creating neuroplasticity. You need to set your body up for success.

• This means nutrition, sleep, quality of life, stress levels, etc.

The Neubie & Autonomic Function

Autonomic Function can play a large role in neurologic disorders such as MS. This can impact fatigue levels, digestion, response time, and our ability to restore function in order to adapt and create NEUROPLASTICITY.

The Neubie can be used to impact autonomic function and parasympathetic activation. The autonomic nervous system (ANS) is a largely unconscious control system that regulates bodily functions like heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal. The ANS is the primary mechanism in control of the fight-or-flight response, and supplies information to the vital organs of the body, including including the blood vessels, stomach, intestine, liver, kidneys, bladder, genitals, lungs, pupils, heart, and sweat, salivary, and digestive glands. The ANS is composed of two divisions: the sympathetic and the parasympathetic. The SNS is generally thought to be what triggers fight-or-flight responses, whereas the PNS triggers rest-and-digest responses. The table below summarizes the effects of these systems on the body.

SYMPATHETIC

OVERALL GOAL

CARDIOVASCULAR EFFECT

Mobilize Energy, spend energy to meet immediate demands, deal with crisis

Increase heart rate, Increase blood pressure

PARASYMPATHETIC

Calm the body, restore and repair, invest resources for longterm projects

Decrease heart rate, Decrease blood pressure

TARGETS FOR BLOOD & ENERGY

Away from visceral and reproductive organs, towards muscles for strength to fight or run away from an attacker

EFFECT ON DIGESTION & ELIMINATION

DECREASE FUNCTION

digestive issues like IBS, constipation

Towards visceral organs for better digestion, waste elimination, reproductive function

INCREASE FUNCTION

healthy digestion, consistent waste elimination

THE NEUFIT SYSTEM

The NeuFit Method uses a combination of muscle testing, manual activation techniques, and the Neubie technology to facilitate neuromuscular re-education for treating neurological disorders, such as Multiple Sclerosis.

Basic Session Flow

PHASE 1 = MUSCLE TESTS AND NEUROLOGICAL BODYWORK

1. Muscle Test to Find Weaknesses

We need to make sure that the neurological signal you need to turn on your muscles can actually get where it needs to go in the first place. If it can’t, no matter what therapy you do, as soon as you go back out into daily life you will collapse into the compromised area and undo all of your progress. If your muscles are turned on and supporting you, then you have a foundation upon which you can actually build something and accumulate progress.

2. Once weaknesses are found, go through Activation Hierarchy to get them turned back on.

Garden Hose Metaphor - kink prevents water from flowing, just like the neurological signals can be blocked. The places we are working will allow us to free up the pathway so that signals can be transmitted again.

PHASE 2 = NEUBIE FOR NEUROMUSCULAR RE-EDUCATION

1. Scanning Assessment Process to find Compensations

Even though the muscles are working now, you may still have compensation patterns. For whatever reason (previous injuries, muscular imbalances, weakness in the neural pathways, etc) your brain may be limiting, governing, or restricting the output of certain muscles. With our device, we can find those patterns. One of the aspects that makes the NEUBIE unique, and allows us to do this type of work, is the way that wave form is shaped to mimic the body’s own neurological signals. It sends the same signals that our bodies send naturally when we move, so when the electrode is on your body it gets interpreted as if movement is taking place. Of course you should be able to move anywhere and everywhere. But, if you have any of those compensation patterns, they’ll kick in and fight against the signal. That’s how we know where to work.

2. Re-Education and Reprogramming

Once we have found these spots that are more reactive and have some sort of defensive reflex, we want to turn the machine up to elicit those same responses and have you perform functional movements through it. In doing this, you can break that pattern and reduce or down-regulate that reflex. That allows you to improve the neurological control of that area and restore proper movement.

THE NEUBIE

At NeuFit, we are committed to advancing rehabilitation and fitness through a revolutionary approach to electrical stimulation. With the Neubie and the NeuFit Method, we have helped thousands of people overcome pain and injury, improve performance, and get back to doing what they love as quickly as possible.

About The Neubie

NEUROMUSCULAR ELECTRICAL STIMULATION (NMES)

The NEUBIE (short for Neuro-Bio-Electric) is a Neuromuscular Electrical Stimulation (NMES) device that uses a Direct Current electrical frequency via pads placed at areas targeted for rehab or training to stimulate muscle, tissue, and nerve activation, and increase blood flow. An NMES device elicits muscle contractions using electrical impulses delivered through electrode pads on the skin. NMES works by delivering impulses to neuromuscular tissue to mimic action potentials from the central nervous system.

The NeuFit Method uses a combination of NMES and functional movements

The NeuFit Method uses a combination of NMES and functional movement because it maximizes the effectiveness of both training modalities. The combination works especially well because it generates neuromuscular adaptations while allowing adjustment of motor control in voluntary movement. When NMES is used in combination with functional training, clients show greater muscular adaptations, improved performance of dynamic movements, and accelerated recovery of muscle contractility and functional abilities.

What does it mean to perform “functional movements”?

Functional movements are movements based on real-world situational biomechanics. This means that the movements are specifically designed with a movement goal in mind. Many MS patients have the goal to walk more efficiently. It would not be reasonable to use the Neubie working on bike riding for the goal of walking. Patients must work on movements that mimic the same muscles and functions required for actual walking along with the inputs from the NEUBIE in order to facilitate neuroplasticity.

Direct

Current (DC) vs. Alternating Current (DC)

DIRECT CURRENT:

• “Mimics” the current of the human nervous system, supercharging our ability for neuromuscular re-education

• Because the signal coming from the device is similar to the body’s own signal, it allows us to work with patients through functional movement, leading to a much higher level of neuromuscular reeducation and a profound patient experience, with most patients (over 90%!) experiencing tangible improvements in pain and/or range of motion after just one session.

• This is an “overall” nervous system approach, rather than specific nerves/muscles to stimulate. In other words, by optimizing the nervous system, the same stimulus that helps relax or lengthen one person’s muscles could actually help with activation and strengthening of another person’s muscles.

• Structurally, the DC electric fields influence the healing process, helping with regeneration of bone, muscle, connective tissue, and nerves

About The Neubie (Continued)

ALTERNATING CURRENT:

• AC devices can be useful for superficial muscle contraction and localized blood flow, but it’s working through more of a “pain-gating” approach, creating a stimulation or “noise” in the body that the brain and nervous system will pay attention to for a little while, but the effects do not last long, and it is not ultimately addressing the root of the problem.

DC is more useful to rehab because it requires less intensity to evoke action potentials within the muscles. AC creates co-contractions within the muscles, making it more difficult to move through the stimulation. “Think about putting your foot on the gas and the break at the same time.” DC achieves more input stimulation compared to AC co-contractions.

MS symptoms the Neubie can help with:

• Fatigue

• Pain

• Spasticity/Spasms

• Muscle weakness

• Balance Problems

• MS Hug

CASE STUDIES

We are committed to advancing the field of rehabilitation by implementing a revolutionary approach to electrical stimulation. Through the utilization of the Neubie device and the NeuFit method, we have helped countless individuals overcome pain and injury, improve performance, and get back to doing what they love as quickly as possible.

CASE STUDY

Improving Gait Quality in a Multiple Sclerosis Patient

PERFORMED BY & LOCATION: Mandy Jacques, Neufit HQ

KEY WORDS:

Improving gait quality with functional strengthening and Neubie DC current in MS patient

DIAGNOSIS:

Patient su ered a SCI 25 years before beginning NeuFit Treatments.

Multiple sclerosis, c/c gait quality and walking with AD, FOF.

TREATMENT AND OUTCOME

Patient diagnosed with Secondary Progressive Multiple Sclerosis. She purchased a Neubie with the goals of improving her gait quality and to be able to walk to her mail box independently. Patient demonstrates with weakness of her hip flexors bilaterally, bilateral foot drop, and genu recurvatum - suggestive of weakness of her quadriceps eccentrically. She walks with a rolling walker or “furniture walks”. Her protocol consists of functional glute, hip, lower leg, and core strengthening, with balance and walking training. Following 3 months in this protocol, patient demonstrates with improvement of foot clearance during gait and balance - as shown by walking to her mailbox with a cane independently. The progress made in this case shows that using the Neubie with functional strength training and an exercise program adhered to the overall goals leads to improvement in strength and overall function.

CLINICAL FINDINGS

Assessment includes gait assessment, standing marching, seated marching, seated dorsiflexion tolerance.

Follow up was bi-weekly for 3 months via video visit. Challenges: Patient was evaluated via video chat due to living in a separate state.

EVALUATION: Manual Muscle Testing (MMT) & scan, AROM and PROM assessment, edema measurements

FINDINGS:

Process: observation of posture/gait

Findings: Bilateral genu recurvatum, foot drop, and hip flexion & knee flexion (foot clearance) during swing phase.

Assessment: these findings are suggestive of weakness of B hip flexors (iliopsoas, rectus femoris), glutes maximus, gluteus minimus, quadriceps, anterior tibialis, posterior tibialis, extensor hallicus.

SUBSEQUENT TREATMENT SESSIONS: 4x/week

RESULTS AFTER ALL TREATMENT COMPLETED (OR CURRENT RESULTS IF STILL BEING TREATED): Able to change AD from RW to SPC. Initially, patient noticed slight regression due to pushing her body too much. Patient educated on the importance of quality movements rather than quantity of movements. Once decreased to 4x/week with quality sets, patient noticed significant improvements.

BEFORE AFTER

DISCUSSION

The strengths of this case report include patient compliance and understanding of the device through education including onboarding course and bi-weekly visits. Limitations include that sessions were done via video visit and there was not a “hands-on” approach due to patient living in a di erent state.

Results show a significant improvement in gait quality as shown during swing phase. Following the Neubie exercise program, the patient’s foot is now able to clear the floor bilaterally. The patient is also using less assistance during gait. Prior to the study she was ambulating with bilateral assist with furniture/walls and a RW in the community. Following the study, the patient is able to ambulate with a SPC. This demonstrates an improvement in Expanded Disability Status Scale (EDSS) score from 6 to 5 (see diagram for details). More therapy will be needed to continue to improve foot clearance as the patient is still not getting full AROM DF during swing phase.

PATIENT PERSPECTIVE

“Working with a Neufit physical therapist over zoom has enabled me to be more confident in my recovery. I'm able to make tiny gains that continue to give me hope for my future. I love that I am able to do this all in the comfort of my home.”