Several research studies have been completed on the effectiveness of the X10. There are more in the works that will be published in late 2017 and early 2018. Excerpts, summaries, and abstracts are present below.

Clinical Brief: The Clinical Evidence Behind the X10™

Authors: Bryan Berquist, Paul Ewing, Dr. Carl Freeman

Clinical Brief

This document provides a clinical overview of the X10 for Pre-hab, MUA (Avoid or Post MUA Recovery), Knee Replacement Recovery, Strength Building. Included here is a primary research study completed in 2012.

Download our Clinical Brief “The Clinical Evidence Behind the X10” here: DOWNLOAD

Are Computer-Controlled, Pressure Modulated Knee Rehabilitation Machines Valuable       

Authors: Drs. Carl Freeman and Paul Roubal


Objective: To determine if a patented new computer controlled, pressure modulated knee rehabilitation machine (PMKR) was more effective, in rehabilitation of total knee arthroplasty (TKA), than the continuous passive motion machine (CPM) utilizing Cochrane Review data.

Design: Patients were treated with PMKR and standard rehabilitation following TKA.

Setting: Outpatient rehabilitation facilities, homebased, and skilled nursing facilities (SNF)

Participants: Prospective study of 197 patients: 59 outpatient rehabilitation facilities; 155 homebased care, and 7 SNF.

Interventions: Patients were prospectively treated with PMKR and standard rehabilitation for TKA.

Main Outcome Measure(s): Range of motion (ROM) was compared (via ANOVA) with the Cochrane CPM Study.   We also evaluated ROM  outcomes versus start day of PMKR use.

Results: PMKR patients ROM, at 30 days, exceeded 116°; significantly greater than all short-term (6 weeks) Cochrane Review studies (83°).  Patients using the PMKR six or more days after surgery had a significantly lower 14-day ROM than patients who began on days 1-5 following surgery.

Conclusions: The PMKR patients increase their ROM following TKA significantly more than CPM users.

Clinical Trial Registration Number: 1152136

Contributions to the Paper:

This investigates a unique PMKR knee rehabilitation device and demonstrates that patient rapidly regain knee ROM following a TKA; had educed rehabilitation time; Possible reduction in failed knee treatments and, a reduction in TKA’s related costs.

  • This is the first paper to report on the efficacy of the PMKR machine.
  • The PMKR is a viable alternative to the discredited CPM for recovering knee patients.

The X10: A Revolution in Knee Rehabilitation Study

Authors: Dr. David Halley and Paul Ewing


Objective: To determine how a patented new computer controlled, pressure modulated knee rehabilitation machine (PMKR) can treat patients with different conditions.

Design: Patients were treated with PMKR and standard rehabilitation following TKA.

Setting: Home-based therapy

Participants: Three Case Studies presented. Case #1: Severely limited right knee joint. Case #2: Typical AGE/AGF knee. Case #3: Middle age female facing MUA 3 weeks post-op.

Interventions: Patients were prospectively treated with PMKR in the home setting.

Main Outcome Measure(s): Patients exhibited faster return to normal life and significant ROM gains using the X10 in the home.

Results: PMKR patients ROM made important gains in all cases.

Conclusions: It seems a reasonable assertion that if a patient can comfortably begin rehabilitation within two to three days following surgery (made possible because of Variable Pressure) there is reasonable expectation that patients will achieve a greater range of motion in a shorter period of time. However this is a secondary goal. It is our primary goal that patients will have a more rapid recovery allowing them to become totally independent, and a member of the workforce, able to return to work in a shorter period of time following surgery.

Download the study here: DOWNLOAD

Building Strength on X10™

Case Report Summary

Author: Bryan Berquist, Dr. Carl Freeman Wayne State University

Timing: Spring 2015

Patient: Kevin McCaig

Surgeon: Dr. Marshall Allegra

A 58-year-old male industrial worker had a right total knee arthroplasty (TKA) due to a work related incident. One month into physical therapy (PT) the therapist ripped the patient’s right leg quadriceps tendon causing the him to cease therapy for 3 months. This patient once again stopped therapy four months later to have an emergency stomach surgery due to a problematic Meckel’s Diverticulum. When the patient was ready to restart his therapy, more than a month after the abdominal surgery, he had only 12 weeks to fully recover and return to work or his employment would be terminated. The patient’s right leg had severely atrophied by this point and his left leg was still atrophied from an incomplete recovery from a partial knee arthroplasty nine months prior to this episode. He required two canes or a walker to ambulate. The surgeon wanted to sign permanent disability papers. The patient chose to begin using the X10™ instead on March 10, 2015.

On May 18th after only 10 weeks of using the X10™ the patient was able to return to work 12 days before his deadline. He did so well his first day back that he actually worked overtime.

To watch an interview with Kevin click here.