A new wave of innovation may reshape how clinicians approach some of the most persistent challenges in patient care. Non-invasive neuromodulation, a technique that uses gentle electrical stimulation to influence brain and nerve activity, is gaining momentum as a powerful tool to improve physical therapy outcomes for patients living with chronic conditions.
At the forefront of this movement, researchers and clinicians are exploring how small, wearable devices, similar in size to an earbud, can enhance physical therapy for individuals with neurological injury or disease. By tapping into the body’s own neural pathways, non-invasive neuromodulation offers a non-pharmaceutical, non-surgical option for managing symptoms and supporting recovery.
Leading this work is Alex Evancho, DPT, a licensed physical therapist and Ph.D. candidate at the University of Alabama at Birmingham. As director of the Adaptive Human Performance Lab within the Center for Engagement in Disability Health and Rehabilitation Sciences, Evancho pairs vagus nerve stimulation with traditional physical therapy to improve motor function and mobility for individuals with Parkinson’s disease.
“We know exercise can help people with Parkinson’s, but the effects don’t always last,” Evancho said. “Neuromodulation may ‘prime’ the brain to make those benefits stick.”
UAB researchers are using a patented earbud-like “hydrobud” to deliver gentle electrical currents through the skin for vagus nerve stimulation, avoiding the need for surgical implants.How neuromodulation works
Transcutaneous vagus nerve stimulation, or tVNS, is a non-invasive type of neuromodulation that delivers gentle electrical pulses to the outer ear, activating the vagus nerve — a key regulator of mood, digestion, inflammation and more.
Unlike traditional vagus nerve stimulation, which requires surgical implants, UAB researchers use a patented “hydrobud” electrode, an earbud-like device that safely delivers mild electrical currents through the skin. This approach is patient-friendly, precise and non-invasive, opening new avenues for neurologic rehabilitation.
Promising results for Parkinson’s patients
In a recent pilot program, Evancho paired non-invasive vagus nerve stimulation with physical therapy for individuals living with Parkinson’s disease. While the study is not yet published, preliminary outcomes suggest a meaningful difference: Those who received the real stimulation maintained their physical improvements for a longer period.
“These early results are exactly what we hoped to see — more durable benefits from therapy,” Evancho said.
The next phase involves securing funding for a larger-scale clinical trial to validate these findings and assess their impact in real-world rehabilitation settings.
Much of this groundbreaking work is happening at CEDHARS, which provides not only the lab space and specialized equipment needed for neuromodulation studies, but also the welcoming, accessible environment that helps participants feel comfortable.
The future of neurologic rehabilitation
While neuromodulation is still an emerging science, interest is rapidly growing. UAB’s unique combination of research innovation, clinical expertise and patient-centered facilities places it at the cutting edge.
And as for Evancho’s long-term goal? To bring neuromodulation out of the lab and into everyday clinics.
“I want this work to directly benefit patients,” Evancho said. “We’re not just trying to prove it works — we want to make it workable in real life.”