Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients

Maja Green,1 Adam Cabble,1 Michael Bailey,2 Maria L Kappell,1 Bart Billet,3 Choll W Kim,4 Jaspal R Singh,5 Manish Suthar,6 Hemant Kalia,7 Shari Kappell,1 Krishnan Chakravarthy1 1Department of Pain Medicine, NXTSTIM Inc., San Diego, CA, USA; 2Department of Neuroscience, Monash University, Clayton, Vi...

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Main Authors: Green M, Cabble A, Bailey M, Kappell ML, Billet B, Kim CW, Singh JR, Suthar M, Kalia H, Kappell S, Chakravarthy K
Format: Article
Language:English
Published: Dove Medical Press 2025-08-01
Series:Journal of Pain Research
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Online Access:https://www.dovepress.com/real-world-effectiveness-of-a-novel-ai-software-dependent-neuromodulat-peer-reviewed-fulltext-article-JPR
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author Green M
Cabble A
Bailey M
Kappell ML
Billet B
Kim CW
Singh JR
Suthar M
Kalia H
Kappell S
Chakravarthy K
author_facet Green M
Cabble A
Bailey M
Kappell ML
Billet B
Kim CW
Singh JR
Suthar M
Kalia H
Kappell S
Chakravarthy K
author_sort Green M
collection DOAJ
description Maja Green,1 Adam Cabble,1 Michael Bailey,2 Maria L Kappell,1 Bart Billet,3 Choll W Kim,4 Jaspal R Singh,5 Manish Suthar,6 Hemant Kalia,7 Shari Kappell,1 Krishnan Chakravarthy1 1Department of Pain Medicine, NXTSTIM Inc., San Diego, CA, USA; 2Department of Neuroscience, Monash University, Clayton, Victoria, Australia; 3Department of Anaesthesiology, AZ Delta Hospital, Roeselare, Belgium; 4Department of Orthopaedic Surgery, Scripps Memorial Hospital, La Jolla, CA, USA; 5Center for Global Health, Weill Cornell Medicine, New York, NY, USA; 6Pain Prevention and Rehabilitation Center, Chesterfield, MO, USA; 7Department of Pain Medicine, Invision Health, Rochester, NY, USACorrespondence: Maja Green, Department of Pain Medicine, NXTSTIM Inc., 5362 Sweetwater Trails, San Diego, CA, 92130, USA, Tel +1 858 910-1778, Email mgreen@nxtstim.comImportance: Chronic pain is a leading cause of disability worldwide, and conventional pharmacologic treatments are often limited by side effects, inadequate efficacy, and risk of dependency. Non-invasive neuromodulation therapies such as TENS and EMS offer alternatives but are traditionally constrained by fixed stimulation protocols and low user engagement.Objective: To evaluate the 24-month real-world effectiveness of EcoAI™, an AI-driven wearable system delivering adaptive TENS and EMS for chronic pain management in community settings.Design, Setting, and participants: This retrospective observational cohort study analyzed de-identified data from 2135 adult users across the United States between January 2023 and March 2025. All users completed at least one therapy session and submitted symptom data via a mobile application.Intervention: EcoAI delivers transcutaneous electrical nerve stimulation (TENS) to modulate afferent pain signaling and electrical muscle stimulation (EMS) to improve local circulation and neuromuscular function. An embedded AI engine dynamically adjusts stimulation intensity, waveform, and duration based on user-reported outcomes and physiological markers.Main Outcomes and Measures: Primary outcome: change in self-reported pain score (0– 10 numeric scale). Secondary outcomes: mood, physical function, social engagement, work activity, and overall well-being. Session adherence and device usage patterns were also analyzed.Results: Across 187,930 recorded sessions, median pain scores declined from 6.0 at baseline to 4.0 at 6 months and 3.0 at 24 months. Statistically significant improvements (p < 0.001) were also observed in secondary domains. Optimal outcomes were achieved with 2– 4 sessions per day lasting 20– 59 minutes. Older adults (≥ 60 years) demonstrated greater engagement and pain relief. No serious adverse events were reported.Conclusions and Relevance: In this retrospective, decentralized study, the EcoAI platform demonstrated sustained, multidimensional benefit in adults with chronic pain. These findings support the potential of AI-driven TENS/EMS as a safe, scalable, and personalized adjunct to pharmacologic care.Keywords: chronic pain, transcutaneous electrical nerve stimulation, TENS, electrical muscle stimulation, EMS, field stimulation, remote therapy monitoring, remote patient monitoring, artificial intelligence, digital therapeutics, real-world evidence
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publishDate 2025-08-01
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spelling doaj-art-757b628450cf4131b3d0effebb88de462025-08-24T17:31:57ZengDove Medical PressJournal of Pain Research1178-70902025-08-01Volume 18Issue 143374348106098Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 PatientsGreen M0Cabble ABailey M1Kappell ML2Billet B3Kim CW4Singh JR5Suthar M6Kalia H7Kappell S8Chakravarthy K9Department of Pain MedicineEpidemiology and Preventive medicineCare ManagementAnaesthesiologySpine SurgeryWeill Cornell MedicineInterventional SpinePhysical Medicine & RehabilitationCompliancePain MedicineMaja Green,1 Adam Cabble,1 Michael Bailey,2 Maria L Kappell,1 Bart Billet,3 Choll W Kim,4 Jaspal R Singh,5 Manish Suthar,6 Hemant Kalia,7 Shari Kappell,1 Krishnan Chakravarthy1 1Department of Pain Medicine, NXTSTIM Inc., San Diego, CA, USA; 2Department of Neuroscience, Monash University, Clayton, Victoria, Australia; 3Department of Anaesthesiology, AZ Delta Hospital, Roeselare, Belgium; 4Department of Orthopaedic Surgery, Scripps Memorial Hospital, La Jolla, CA, USA; 5Center for Global Health, Weill Cornell Medicine, New York, NY, USA; 6Pain Prevention and Rehabilitation Center, Chesterfield, MO, USA; 7Department of Pain Medicine, Invision Health, Rochester, NY, USACorrespondence: Maja Green, Department of Pain Medicine, NXTSTIM Inc., 5362 Sweetwater Trails, San Diego, CA, 92130, USA, Tel +1 858 910-1778, Email mgreen@nxtstim.comImportance: Chronic pain is a leading cause of disability worldwide, and conventional pharmacologic treatments are often limited by side effects, inadequate efficacy, and risk of dependency. Non-invasive neuromodulation therapies such as TENS and EMS offer alternatives but are traditionally constrained by fixed stimulation protocols and low user engagement.Objective: To evaluate the 24-month real-world effectiveness of EcoAI™, an AI-driven wearable system delivering adaptive TENS and EMS for chronic pain management in community settings.Design, Setting, and participants: This retrospective observational cohort study analyzed de-identified data from 2135 adult users across the United States between January 2023 and March 2025. All users completed at least one therapy session and submitted symptom data via a mobile application.Intervention: EcoAI delivers transcutaneous electrical nerve stimulation (TENS) to modulate afferent pain signaling and electrical muscle stimulation (EMS) to improve local circulation and neuromuscular function. An embedded AI engine dynamically adjusts stimulation intensity, waveform, and duration based on user-reported outcomes and physiological markers.Main Outcomes and Measures: Primary outcome: change in self-reported pain score (0– 10 numeric scale). Secondary outcomes: mood, physical function, social engagement, work activity, and overall well-being. Session adherence and device usage patterns were also analyzed.Results: Across 187,930 recorded sessions, median pain scores declined from 6.0 at baseline to 4.0 at 6 months and 3.0 at 24 months. Statistically significant improvements (p < 0.001) were also observed in secondary domains. Optimal outcomes were achieved with 2– 4 sessions per day lasting 20– 59 minutes. Older adults (≥ 60 years) demonstrated greater engagement and pain relief. No serious adverse events were reported.Conclusions and Relevance: In this retrospective, decentralized study, the EcoAI platform demonstrated sustained, multidimensional benefit in adults with chronic pain. These findings support the potential of AI-driven TENS/EMS as a safe, scalable, and personalized adjunct to pharmacologic care.Keywords: chronic pain, transcutaneous electrical nerve stimulation, TENS, electrical muscle stimulation, EMS, field stimulation, remote therapy monitoring, remote patient monitoring, artificial intelligence, digital therapeutics, real-world evidencehttps://www.dovepress.com/real-world-effectiveness-of-a-novel-ai-software-dependent-neuromodulat-peer-reviewed-fulltext-article-JPRChronic painTranscutaneous electrical nerve stimulationTENSElectrical muscle stimulationEMSField stimulation
spellingShingle Green M
Cabble A
Bailey M
Kappell ML
Billet B
Kim CW
Singh JR
Suthar M
Kalia H
Kappell S
Chakravarthy K
Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
Journal of Pain Research
Chronic pain
Transcutaneous electrical nerve stimulation
TENS
Electrical muscle stimulation
EMS
Field stimulation
title Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
title_full Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
title_fullStr Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
title_full_unstemmed Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
title_short Real-World Effectiveness of a Novel AI-Software Dependent Neuromodulation (ASDN) with Remote Monitoring Capability Field Stimulation Device for Chronic Pain: A 24-Month Analysis of Over 2000 Patients
title_sort real world effectiveness of a novel ai software dependent neuromodulation asdn with remote monitoring capability field stimulation device for chronic pain a 24 month analysis of over 2000 patients
topic Chronic pain
Transcutaneous electrical nerve stimulation
TENS
Electrical muscle stimulation
EMS
Field stimulation
url https://www.dovepress.com/real-world-effectiveness-of-a-novel-ai-software-dependent-neuromodulat-peer-reviewed-fulltext-article-JPR
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