I would have rated it as excellent except that we were told that with the “Y” connector we could run 2 cuffs at the same time. We tried and they run about 8-10 degrees warmer (Estimate) with both hooked up. This is not acceptable to us. We called and they asked if we had added extra water with 2 connected? We said yes, and tried again still not acceptable. Then a factory rep called us and said the same thing, said he would call back to try it again. We tried it again but results were no better. He didn’t call back so I called and left a message, over a week has gone by with no satisfaction or returned call. The “Y” connector and straight knee sleeve is drained and back in their bags, they are of no use to use to us and almost $900 Sitting here wasted. I would have liked to have a refund for the these items. So later when I hurt something else I would order that sleeve for that body part then.