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A VeRelief Case Study: Panic Attacks – Hoolest Inc.
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A VeRelief Case Study: Panic Attacks

A VeRelief Case Study: Panic Attacks

Chronic pain affects millions of people worldwide, often leading to a vicious cycle of stress, anxiety, and further health complications. Physical therapists frequently use mindfulness meditation techniques such as body scans, sitting meditation, and Hatha yoga to help manage this pain. These methods aim to break the cycle by reducing fear of movement and catastrophic thinking. However, recent advancements in technology have introduced additional tools to aid in this process, such as the vagus nerve stimulator.


Understanding Mindfulness Meditation in Physical Therapy

Mindfulness meditation focuses on the connection between mind and body, which is crucial for managing chronic pain. Conditions like anxiety and post-traumatic stress disorder (PTSD) can exacerbate pain sensations, leading to increased medication use and decreased social interaction. By employing mindfulness techniques, physical therapists aim to help patients lower their fear of movement and reduce the tendency to catastrophize their pain.


Introducing Vagus Nerve Stimulation for Anxiety Relief

A new approach involves the use of vagus nerve stimulation (VNS) devices, which assist in relaxation and modulating anxiety symptoms. Specifically, transcutaneous vagus nerve stimulation (tVNS) targets the auricular branch of the vagus nerve around the ear. This non-invasive method has shown promise in relieving symptoms of major depressive disorder and other anxiety-related conditions.


Case Study: Evaluating a Novel tVNS Device for Anxiety and Panic Attacks

A recent study aimed to determine the efficacy and feasibility of a new tVNS device developed by Hoolest Performance Technologies. The subject of the study was a 23-year-old male who had suffered multiple amputations due to necrotizing fasciitis. His condition resulted in severe anxiety, panic attacks, muscle spasms, and chronic pain.



The first-generation VeRelief tVNS device was provided to the patient, designed to stimulate the auricular vagus nerve just behind the ear at frequencies ranging from 25-450Hz. The patient used the device for 8 weeks, twice daily for 4-5 minutes, and provided feedback through weekly electronic surveys. The surveys assessed the usability and effectiveness of the devices, with responses measured on a scale from "Strongly Disagree" to "Strongly Agree."


The results were promising:

  • Overall Improvement: The patient felt better after using the device (63% Strongly Agree, 38% Agree).
  • Symptom Reduction: The severity of his symptoms decreased (75% Agree, 25% Neutral).
  • Predictability: The effect on his symptoms was predictable (13% Strongly Agree, 75% Agree, 13% Neutral).
  • Sense of Security: He felt better having access to the device in case of symptoms (25% Strongly Agree, 75% Agree).

The patient reported, “It has stopped some panic attacks from getting worse and [felt like] I was melting into my bed. Complete mental and physical relaxation.” He also appreciated the relaxation benefits after workouts, which helped with muscle soreness and spasms.


The VeRelief tVNS device proved to be a feasible adjunct tool for decreasing symptoms of anxiety and panic disorder in individuals with chronic pain. Although the study was conducted during the COVID-19 pandemic, limiting the use to home settings, the patient believed the device would also be beneficial for meditation after physical therapy sessions. The ease of access provided significant relief at the onset of panic attacks, showcasing the device's potential as a valuable addition to physical therapy practices.

Final Thoughts

The integration of mindfulness meditation and vagus nerve stimulation offers a comprehensive approach to managing chronic pain and anxiety. By combining traditional physical therapy techniques with innovative technology, patients can achieve better outcomes and improved quality of life. As more research unfolds, the use of VeRelief devices may become a standard practice in physical therapy, providing much-needed relief to those suffering from chronic pain and anxiety.

Authors and Acknowledgements

Dr. Linda Denney, Physical Therapy and Athletic Training Dept. Northern Arizona-Phoenix Biomedical Campus. Phoenix, AZ. 

Dr. Nicholas Hool, Tyler Neuroperformance Lab. Arizona State University. 

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