Geko™ FAQs

 


What is the geko™ device? +
The geko™ device, utilising OnPulse™ neuromuscular electrostimulation technology, is clinically proven to enhance blood circulation in various in-hospital therapy areas, including the prevention of venous thrombosis (VTE) and the management of oedema.
What does it do? +
The geko™ device, utilising OnPulse™ neuromuscular electrostimulation technology, is clinically proven to enhance blood circulation in various in-hospital therapy areas, including the prevention of venous thrombosis (VTE) and the management of oedema.
How does it work? +
The easy-to-use geko™ device is a battery-powered, disposable neuromuscular electrostimulation device designed to increase blood flow in the deep veins of the leg. It gently stimulates the common peroneal nerve, activating the calf and foot muscle pumps, resulting in increased blood flow and a reduction in oedema.
  
Powered by a wristwatch-sized battery and controlled by plus and minus buttons, the self-adhesive geko™ device comfortably moulds to the leg. Green flashing LED lights indicate when the device is switched on and display the selected stimulation level.On the underside of the strap, covered by a water-based conductive hydrogel for secure adhesion, negative and positive electrodes deliver painless neuromuscular electrostimulation. 
Who uses it? +
The geko™ device, typically used in a clinic or home care setting, is also employed in hospitals by front-line staff, including tissue viability nurses, vascular surgeons, wound care specialists, consultant surgeons, nursing staff, and physiotherapists.
Where is it worn? +

The geko™ device is intended for use only on the lower limbs. Secure the device to the leg so that the location marker (the line of arrows) is positioned directly over the centre of the fibula head. When correctly fitted, the longer tail should wrap around to the back of the leg, below and parallel to the crease of the knee.

 

This positioning ensures the negative electrode is placed over the common peroneal nerve, with the ‘plus’ button at the front of the leg and the ‘minus’ button at the rear. The device can also be applied in two alternative locations: just above or just below the crease of the knee, aligned with the lateral outer tendon.

How long should it be worn? +

Hospital Application
The healthcare professional prescribing the geko™ device will provide guidance on the wear protocol based on your condition. For example, to prevent venous thromboembolism, the device should be worn on both legs for 24 hours per day during the acute phase (the first 1 to 6 days).

Wound Care

  • Each geko™ device provides two days of treatment and should be worn for 12 hours per day. Treatment can be paused, and the device may be removed for short periods (up to three hours in total) for activities such as washing, driving, or undergoing various tests.

  • Between treatments, the geko™ device should be removed and stored on the backing card provided. It is essential not to leave the device on your skin during the 12-hour break, as this allows your skin time to breathe between treatments.

  • A minimum 6-hour break is required between each 12-hour treatment. If you attempt to start the device too soon, it will emit a single long flash (0.5 seconds) and will not stimulate. The device will automatically switch off after 12 hours. If the device has been paused, it will resume and continue until the full 12-hour treatment is complete, so there’s no need to worry about tracking the time—it does it for you.
Why is there a limited run-time on the T device? +
The lifespan of the geko™ device is controlled by a clock within the device’s software. Extensive testing has shown that by the expiry date, the battery still has sufficient capacity to operate reliably for 30 hours at the maximum setting. As the battery loses capacity, its voltage drops, and below a certain threshold, the device may not function reliably. To ensure effective VTE prophylaxis, the device must operate consistently. The 30-hour battery life allows for 24 hours of continuous operation, with a reserve to provide busy staff enough time to change the device and maintain uninterrupted 24-hour VTE prophylaxis.
What’s the correct stimulation level? +
When activated, observe for a noticeable movement of the muscles in the lower leg and a visible outward and upward movement of the foot. It is not sufficient to see only a slight movement in the lower leg muscles alone; the movement in both the lower leg and foot should be clearly discernible.
Is it painful? +
No, there is no sensation of pain. You may feel the muscles in your lower leg contracting every second, which can take a few moments to get used to. After that, it’s common to forget you are even wearing the device.
Can I sleep with it on? +
There is no detrimental effect to sleeping while wearing the devices. However, if you find the devices disruptive, discuss this with your healthcare professional, who may advise you to either lower the settings or turn them off completely, if that aligns with your treatment plan.
Is it waterproof? +
The geko™ device must be kept clean and dry. Do not bathe or shower while wearing the device, as prolonged exposure to water will soften the hydrogel and may cause the device to lose adhesion. Immersion in water may also affect the electronics and prevent proper operation. If the device becomes wet, either from water or bodily fluids, there is no danger to the patient. The adhesive gel is water-based, so slight dampening of the gel will make it easier to remove the device from the leg once treatment is complete.
Single-use or reusable? +

Hospital Application

The geko™ is a single-use medical device, meaning it is designed for use on a single patient as part of a single course of treatment.

Wound Therapy

For wound therapy, the geko™ device should be used for a maximum of two days before being discarded. The device can be stored on the backing card between uses. Please refer to the Instructions for Use (IFU) for further details.

How is it different from other electrostimulation devices? +
The geko™ device is unique in that it delivers neuromuscular electrostimulation via the common peroneal nerve to activate the calf and foot muscle pumps of the lower leg, unlike other electrostimulation devices that stimulate the muscles directly and may be less well tolerated.
NMES vs TENS—what’s the difference? +
NMES differs from transcutaneous or percutaneous electrical nerve stimulation (TENS), in that NMES stimulation is directed to the motor nerves and TENS is directed to the sensory nerves.
What pulse does it use? +

The geko™ device delivers a constant current, square wave, asymmetrical, charge-balanced pulse. The term “constant current” refers to the device’s ability to maintain a consistent output during the duration of the pulse. The device’s voltage adjusts according to the patient’s electrical resistance to ensure the required current output is achieved.

 

The stimulation pulse is described as a square wave, meaning the current rapidly rises to the desired value, remains constant for the duration of the pulse, and then quickly drops back to zero. This creates a rectangular or square shape when viewed on an oscilloscope, hence the name “square wave.”

 

Following the primary stimulation pulse, there is a return pulse of lower intensity but longer duration, with opposite polarity (asymmetrical) to ensure the total electrical charge is zero (charge-balanced). This charge-balancing feature helps prevent electrochemical changes in the skin.

How much blood-flow increase is seen? +
Clinical studies report increased venous blood flow at rest, with dorsiflexion achieved by the device comparable to a substantial portion of walking.
What about pacemakers or other implants? +
No unsafe interactions have been reported under standards compliance, but implanted systems vary—use clinical judgment and follow IFU and local guidance.