Evidence Based Treatment Protocol

While all range of motion mechanical therapy devices most likely have a clinically based protocol, many patients find them difficult to use or wear, so compliance is low and the devices are less practical and less effective. ERMI devices are designed with both clinical evidence (i.e. scientifically based results) and the patient’s compliance and use in mind. 

Consequently, ERMI devices are increasingly recommended and prescribed by Clinicians for both new patients who never tried similar products and often confuse ERMI devices with competitive low intensity devices) and those patients, who failed treatment with seemingly similar devices due to complications associated with disease and/ or low compliance and use.

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Clinical research explains that improving your motion requires the balancing of multiple biomechanical factors. A fundamental biomechanics’ principle was studied in the 1990’s, now known as the Total End Range Time (TERT) method.  TERT informs how ERMI devices can effectively stretch and treat scar tissue. In landmark research, a study of shoulders advanced our understanding of shoulder motion loss, and established a benchmark for effective treatments of motion loss. [Learn More]


ERMI devices are designed and engineered with the same considerations to mimic the Intensity and Duration that a physical therapist balances, but a similar intensity and duration is managed under the patient’s own control. He or she is motivated because they have control to treat themselves. By also focusing on creating a superior patient experience that is easier to use ‘in home’ as an adjunct to physical therapy, the company finds that the patient uses the device more frequently, and is highly compliant. 

  • ERMI general treatment protocol properly balances all 3 key factors. (Specific protocol for each individual patient is determined by the treating physician and therapist and ERMI works in support and in partnership.)
  • General guidelines:
    • Stretch at a high intensity for 10 minutes, rest for 10 minutes, and then stretch for 10 minutes again.
    • Repeat that 2 more times during the day and you will achieve the target of 60 minutes per day.
    • You can break it up into smaller time periods if necessary. For example, you could stretch for 5 minutes, rest for 5 minutes, and then stretch for 5 minutes again. You would then need to repeat this 5 more times during the day to get to the 60 minute target for stretching in “End Range”.

Our experience and ever increasing body of clinically published evidence is that ERMI produces superior outcomes for those with severe motion loss. Interested in learning more about our proven results?   [Learn More]


  1. Noyes F, Barber-Westin S. Prevention and treatment of knee arthrofibrosis. Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes. F. R. Noyes, editor. Philadelphia: Saunders/Elsevier; 1st edition, 2010. Pages 1053-1095.
  2. Davies G, Ellenbecker T. Focused exercise aids shoulder hypomobility. Biomechanics 1999, Nov.
  3. Cummings G, Tillman L. Remodeling of dense connective tissue in normal adult tissues: In Currier D, Nelson R, editors. Dynamics of Human Biologic Tissues. Philadelphia: F. A. Davis Company;1992. Pages 45-73.


Patients who do not make expected range of motion gains face an increasingly time sensitive problem because the healing processes associated with scar tissue forming around the joint have the unintended consequence of creating complications, if not treated effectively.

Identification of an effective solution is left not only to an awareness that a problem is emerging but also to an awareness that ERMI devices are an alternative solution when conventional treatment fails, and a more aggressive treatment is needed. There is a general misunderstanding that all mechanical devices are the same, and they are used for the same purpose and during the same natural history or continuum of care of a patient.

ERMI devices for knees, shoulders, elbows, big toes, have been designed for severe motion loss patients. ERMI is a provider and partner to treating clinicians and healthcare professionals who have outlier patients, where normal conventional treatments are failing to make desired gains. As treating clinicians establish what is normal, ERMI provides a non-invasive solution to lower avoidable healthcare costs associated with more complex patients cases, and downstream procedures.

Early identification of patients who face treatment failures is important to manage care, to produce successful outcomes and to avoid added healthcare costs.