Background: The use of electrical impulses, including deep brain stimulation and spinal cord stimulation, to help resolve chronic pain has been around since the 1960's. This form of treatment is referred to as neuromodulation. For decades, physicians have continued to develop new therapeutic approaches to very serious and debilitating chronic pain conditions, and as goes everything in healthcare, newer and less invasive devices are produced optimizing client usage and enhancing therapeutic benefit. Historically neuromodulation would be thought of with more invasive treatments such as spinal cord stimulators for chronic low back pain, or deep brain stimulators for Parkinson’s disease. Recently, with the evolution of percussion devices there is interest in evaluating the use specific to the effects of low voltage electrical current on inhibiting pain signals and/or stimulating neural impulses in regions that were previously absent.

Our Clinical Question: Can the Hypervolt be applied to a muscle that is inhibited and manifest a tetany type response, like that created with NMES? We have outlined several ongoing clinical trials in our practice, two that we’d like to share with other clinicians as they are low cost and very efficiently performed in the clinical setting.

Trial 1 – Utilizes Hypervolt treatment to the quadriceps and uses the mTrigger biofeedback device to measure activation pre and post percussive session.

  • The protocol:
    • Using the mTrigger device, a Neuromuscular deficit test is performed to determine the percentage deficit involved:uninvolved.
    • The patient then rests for 5 minutes toallow restoration of homeostasis.
    • Following therest period, 1 minute of Hypervolt to the involved quadricep musculature is performed (trials at both 30 and 40 Hz)
    • The Neuromuscular deficit test is repeated.
  • The results:
    • The protocol has been performed at both 30 HZ and 40 HZ, the results have shown improved quad activation, and less deficit demonstrated in the range of 10-25%.


Trial 2 – Utilizes Hypervolt treatment to the lower extremity in those demonstrating deficits in force output measured on a sled push test on the Technogym Skillrun.

  • The protocol:
    • Pre-test on the Technogym Skillrun.
    • The Hypervolt is then used, at 40HZ, to the extremity demonstrating the least force output during the pre-test.
    • The test protocol is then repeated.
  • The results:
    • Initial data gathered shows an increase of 3-12% force output on the extremity post use of Hypervolt percussion.

Discussion: Current literature supports the use of low voltage electrical current, specifically in its neuromodulation ofpain and muscular re-education. It is also supportive of the benefits to the soft tissues, primarily the metabolic changes, neural adaptations, and resistance to fatigue. With regard to-our own intra clinic studies using percussion devices, we ask ourselves this question: are we  truly getting a modulated response of the neuromuscular system, or are we simply getting a learned response? More robust data collection can assist in answering that, but in the meantime, as clinicians, we will take either one or both!

If percussion devices can evoke a reaction that has been acquired by learning to awaken the neuromuscular system, and/or the use of low voltage electrical current can stimulate neural impulses in regions that were previously absent, then I have facilitated positive gains for my client. Having utilized the percussion devices for years, both on the clinic side and performance side, we have subjectively heard the overwhelming support for their use. Patients and athletes, once they try them, want them for home. As a team, we have now turned our attention to the more objective side, exploring new uses, gathering data, and not turning a blind eye to what the literature already tells us regarding the benefits of low voltage electrical stimulation.