Neuromuscular Electrical Stimulation (NMES), also referred to as e-stim, has long been dominated by VitalStim—but Ampcare is offering a compelling alternative that deserves attention.
While Ampcare may not be new to the scene (they’ve been researching NMES for swallowing since 1993), their system has recently gained FDA approval and is becoming more widely used.
I had the chance to sit down with Russ and Rick from Ampcare at the ASHA convention, and I was impressed with what they had to share—not only about the product itself but about how it differentiates from others in the market.
The Electrodes: Comfort and Cost-Efficiency
One of the biggest differences with Ampcare is in the design and function of the electrodes.
- Larger Surface Area: Unlike smaller electrodes that can create painful “hot spots,” Ampcare’s larger electrodes distribute stimulation more evenly. This allows for higher intensity with greater comfort.
- Low Impedance: Ampcare electrodes offer 10 Ohms of impedance compared to VitalStim’s 30 Ohms or less, resulting in more efficient and comfortable current delivery.
- Targeted Placement: Designed to fit directly over the submental muscles responsible for hyolaryngeal elevation and anterior movement of the hyoid.
- Latex-Free and Cost-Effective: With 4 electrodes per package and the potential for 5 uses each, the cost per session is significantly lower than other brands.
Electrode Cost Comparison
| Product | Quantity | Price | Cost per Use |
|---|---|---|---|
| Ampcare | 40 electrodes (use 5x each) | $119.50 | ~$0.24 |
| VitalStim | 12 electrodes (single use) | $209.00 | $17.42 |
| Freedom Electrodes | 12 electrodes (single use) | $159.00 | $13.25 |
| Alternative Electrodes | 40 electrodes (single use) | $108.50 | $2.71 |
Ampcare clearly offers the most cost-effective option—especially when used correctly across sessions.
The Restorative Posture Device (RPD)
Ampcare also offers a unique posture device designed to support head and neck alignment during swallowing. The RPD is indicated for patients with:
- Forward head posture
- Weakness in neck musculature
- Reduced cervical range of motion
Not only does the RPD assist with posture during eating, but it also serves as a resistive device for chin-tuck exercises, similar to the Shaker or “Neckline Slimmer” alternatives.
Cost: $100.00
The NMES Device: More Customization, Better Control
What really sets Ampcare apart is the device itself. Unlike the VitalStim system, Ampcare allows clinicians to set individualized treatment parameters.
Device Comparison
| Feature | Ampcare | VitalStim |
|---|---|---|
| Treatment Time | 5–30 minutes | Up to 60 minutes |
| Output | 0–100 mAmps | 25 mAmps |
| Frequency | 5–50 Hz | 80 Hz |
| Phase Duration | 50–250 µs | 300 µs |
| Cycle Time | 5/15, 5/20, 5/25 | 59/1 |
| Ramp Time | 1 second | Not adjustable |
| Channels | Single or Co-Contraction | Dual |
VitalStim’s cycle of 59 seconds “on” and 1 second “off” can result in sustained muscle contraction far beyond what is functional or physiologically appropriate. Ampcare’s 5-second “on” time targets fast-twitch Type II muscle fibers more effectively and mirrors natural swallow function.
The Protocol: ESP (Effective Swallowing Protocol)
Ampcare’s ESP protocol involves:
- 30 minutes of stimulation
- Exercises during stimulation: Mendelsohn maneuver, effortful swallow, and chin tuck (using RPD)
- Dry swallows during the stimulation “on” time
- Food trials during the “off” cycle
Clinical Outcomes
In one case series presented by Ampcare:
- 3 of 5 NPO patients returned to an oral diet
- No regression in function was noted post-therapy
- Fluoroscopy footage showed dramatic hyoid movement during stimulation
Key Takeaways: Why Consider Ampcare?
- ✅ 5-second “on” stimulation mimics natural muscle contraction better than long holds
- ✅ Electrodes target submental muscles without downward pull
- ✅ Dry swallows are used during stimulation for increased resistance and functional training
- ✅ Lower frequencies increase comfort while allowing for higher mAmps
- ✅ Cost-effective electrode design and reusable options
- ✅ Integrated posture support tool for added therapy benefit
Want to Learn More?
You can explore Ampcare’s courses and products on their website. Training costs just over $300 and includes:
- One pack of FDA-cleared Ampcare E-Series Electrodes
- One posture device (RPD)
- Course materials
Note: Prices may vary.
I’ve taken the training twice and HIGHLY recommend it, even though I’m not currently using Ampcare in clinical practice and am not affiliated with the company.
Are you ready for a deeper dive with even more resources available? Join the Dysphagia Skills Accelerator today. You will get so many great tools with new tools being added all the time! Click here to join now!
Have you ever wanted a way to create a more standardized protocol for your Clinical Swallow Evaluation? Do you often forget or leave out parts of the CSE, you know, the parts that are important for your Plan of Care? You probably need the Clinical Dysphagia Assessment Toolkit if you answered yes. You can get your copy here.
References:
Beavan, J. (2015). Update on management options for dysphagia after acute stroke. British Journal of Neuroscience Nursing, 11(Sup2), 10-19.
Pownall, S., & Enderby, P. (2003). stimulation on swallowing. J Appl Physiol, 94, 128-134.
Martindale, N., Stephenson, J., & Pownall, S. (2019). Neuromuscular Electrical Stimulation Plus Rehabilitative Exercise as a Treatment for Dysphagia in Stroke and Non-Stroke Patients in an NHS Setting: Feasibility and Outcomes. Geriatrics, 4(4), 53.
Diéguez-Pérez, I., & Leirós-Rodríguez, R. (2020). Effectiveness of Different Application Parameters of Neuromuscular Electrical Stimulation for the Treatment of Dysphagia after a Stroke: A Systematic Review. Journal of Clinical Medicine, 9(8), 2618.
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