Specialist commentator comments
Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.
One of the commentators has used the device with 9 patients (each using the suit for 1 hour) as part of a trial with the manufacturer. Two other commentators were familiar with the technology, but 1 stated that this was only through reading of the literature and neither had used the technology with their own patients. None of the commentators were involved in the development of the technology.
One commentator stated that the use of electrical stimulation for the treatment of medical disorders has been limited because of lack of efficacy and tolerance by patients, especially children with learning disabilities. However, they added that the Mollii suit is a promising concept because current treatments, such as medication and surgical options, are associated with side effects, need monitoring or are expensive to administer. A second commentator stated that the Mollii suit is completely new compared with existing technologies and there is no other whole-body sub-threshold electrical stimulation suit currently available. This commentator was not aware of any other technology that would already supersede or replace this technology. A third commentator felt that more evidence would be needed to determine the benefits of the technology.
One commentator remarked that for people with neurological impairment, the device could have a large effect, including reducing spasticity, increasing muscle strength and control and decreasing stiffness and pain associated with tone and lack of movement. This could reduce the need for drug therapy and increase quality of life, as well as improve recovery after injury. They reflected that in their limited experience of using the Mollii suit, each of the people who had used the suit experienced benefits.
A second commentator noted that several benefits have been proposed in the literature, such as improved muscle mass, increased range of movement, improved walking speeds and improved posture. They added that this could be helpful to prevent secondary musculoskeletal complications, especially in children with cerebral palsy, stroke and other acquired brain injuries. This commentator also stated that children with unilateral spastic disorders (of static causes) might benefit more than children with severe spastic quadriplegic cerebral palsy, although more long-term studies are needed to confirm this.
A third commentator stated that the current evidence is insufficient to draw any conclusions about potential patient benefit. They note that obnoxious stimuli can trigger spasticity and further research is needed to establish if the Mollii suit could cause harm to patients.
One commentator reported that the person providing the assessment for use of the technology would need training and also noted that additional storage and washing facilities would be needed. This commentator believed the person using the suit would need minimal training. A second commentator felt that use of the technology would not need, or lead to, any significant changes in facilities or infrastructure.
One commentator felt the technology could reduce costs by increasing the speed of recovery and reducing the need for drug therapy. Another commented that in theory the technology could lead to fewer hospital visits but several factors may influence this outcome (for example, the severity of spasticity, level of cognitive impairment, and other co-morbidities could mean the technology may not be suitable for all patients). Two commentators noted that there is a lack of evidence on the cost impact of the device.