Awesome bit of kit, makes a rough gravel ride as smooth as a peach. Feels weird to begin with but doesn't affect the handling and performance of the bike. No wrist or arm fatigue, have used it on road, gravel and forest tracks and I wouldn't be without it.
Works extremely well at smoothing out the vibrations at the handlebars on my road bike when I am on the hoods.
Can sometimes notice a slight movement on a very steep ascent when I am out of the saddle but not to the extent that it effects my climbing.
Not a cheap stem but well worth the investment if you ride a lot.