Car accidents, falls, voluntary or involuntary participation in violent acts and the blows suffered in certain sports are usually behind spinal injuries, but they are not the only causes. Cancer, arthritis, osteoporosis and inflammation of the spinal cord can also cause such injuries. Mobility here is the most affected function and, with it, comes a series of associated physical and psychological conditions.
Recovering mobility after suffering a spinal cord injury or stroke is complex, and not just because of a matter of physical will or ability. It is essential to have the necessary professional help, and this without even talking about the time it takes to start a recovery process and see its results. In addition, we all know very well that the word time in medical therapies is proportionally equivalent to money, huge expenses and often impossible to assume for the vast majority of those affected.
The use of exoskeletons to help those affected by spinal injuries in their recovery is certainly not something new, although the real revolution could come with two features so far absent in these devices: less weight and greater affordability.
And most of the now existing exoskeletons weigh more than 20 kilograms and cost more than $ 100,000 dollars. Consequently, these teams are usually only in the possession of hospitals and institutions, and require qualified personnel to operate them. But what if it were possible to take these exoskeletons home and use them as will be done with crutches or more common orthopedic equipment?
This has been precisely the vision of ABLE Human Motion, a young company (never better said) born in Barcelona, Spain, and that in a few years has added a host of awards, without the hope of thousands of people who now see a more reachable and easier possibility of moving again with greater independence.
Among the most common causes of paralysis, are stroke and spinal cord injury, and WHO estimates that there are 500,000 new cases each year. We speak then of a technology that could mean a revolutionary advance for many patients, who will help alleviate the complications associated with injury with a sedentary lifestyle such as spasticity, chronic pain, osteoporosis or cardiovascular and digestive problems, all this without counting on the serious social and psychological consequences that it supposes.
A passionate and nurtured multidisciplinary team is behind the company: engineers, physiotherapists, doctors, rehabilitators and, of course, orthopedic technicians. At the head of all of them, Alfons Carnicero, industrial and biomedical engineer, co-founder and CEO of ABLE Human Motion, who between prize and prize, between talks and presentations answered the questions of Digital Trends in Spanish.
Why did you decide to create ABLE Human Motion?
Since I was little, there are two things that have fascinated me: technology and sports. During my studies I always tried to apply the knowledge learned to the sport: I worked with players of FC Barcelona basketball to improve their launching technique, and with athletes from the High Performance Center of Sant Cugat to study their long jump technique. However, when I was finishing my Industrial Engineering Degree, my father suffered a stroke, something that changed the focus of my professional career.
“He studied the Biomedical specialization of the Master of Industrial Engineering and worked at the Institut Guttmann, where he discovered the limitations of current rehabilitation technologies, and Implantcast, a German company where he designed knee implants. With the mission of improving the quality of life of people with disabilities, ABLE Human Motion cofund, a spin-off of the UPC where we develop lightweight, easy-to-use and economical robotic exoskeletons. ”
We are already seeing how this idea came about… How long has the team been working on it?
The initial idea arises in 2013 from a doctor from La Corua (northern Spain), who observed that a group of patients did not have devices adapted to their needs (spinal injuries below the thoracic vertebra 10), but only robotic exoskeletons thought for any paraplegia, which are practically inaccessible to the average citizen (they cost about 100,000 euros: more than $ 110,000 dollars) and little verstiles for the day to day (they weigh about 20 kg). There was born a joint investigation between the Universitat Politcnica de Catalua (UPC), Corua (UDC) and Extremadura (UEX) that gave rise to the first prototypes of this lightweight, easy-to-use and economical exoskeleton.
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“From Barcelona, the research was led by Dr. Josep Maria Font, Director of the Biomechanical Engineering Laboratory (BIOMEC) of the UPC and co-founder and Scientific Director of ABLE Human Motion. I joined when it was still a research project, studying the feasibility of taking it to the market and participating in the CaixaImpulse program of Fundacion La Caixa and Caixa Capital Riesgo. There we received 70,000 euros and the necessary mentoring support, regulatory training sessions, technology transfer, intellectual protection, finance to determine that the business could be viable. We did more than 100 interviews with doctors, patients and physiotherapists, and we saw that there was a medical need not covered and with a relevant market that our product solved ”.
Our main objective: to bring exoskeleton technology home.
“We also detected that to convert the prototype into a robust and commercial product we would need a Technical Director. It was then that we spoke with Alex Garca, who had studied with me at the university and at that time was working at a technology company in Barcelona. We convinced him to join this exciting and daring adventure. ”
What makes ABLE different from its competitors?
Instead of trying to address any type of mobility problem with a single device, we focus on patients with spinal injuries that preserve some hip mobility (lesions below the thoracic vertebra 10). This, together with years of research at UPC and external collaborations, has led to a patented system to help you walk, which compared to existing solutions is up to 5 times smaller essential for the acceptance of daily use and up to 3 times lighter , important thing to facilitate its portability. And the best: it is up to 8 times cheaper. This puts us in a unique position to achieve our main objective: to bring the exoskeleton technology home.
"We are also starting to develop a device for stroke survivors, which will promote their rehabilitation and independence in daily life."
What difficulties have you encountered in moving this project forward?
Along the way you encounter many difficulties and obstacles, the important thing is to learn from mistakes and persist. For example, I remember that the first times we presented the project to investors we did not succeed. But we improve the message and look for more specialized investors who understood the peculiarities of the medical sector (longer times, regulatory, clinical tests, marketing strategy). Once the first investors were convinced, closing the round was much easier. In fact, there were so many interested parties that we expanded the size of the investment to 700,000 and had to say "no" to several investors.
“Another difficulty has been to get involved with the right people and companies. Being young, for us it was very important to select a group of expert advisors with an extensive network of contacts and ability to help solve the problems that arise along the way. Also be aware of the capabilities of the team and seek help from expert companies that believe in the project and help to push it forward. ”
“Something we find is the lack of innovation in the current rehabilitation process. In many centers the same devices and therapies that 50 years ago for standing and reeducation of the march are still used, and it is a challenge to introduce an innovative device like ours to the clinical professionals, accustomed to making manual mobilizations ”.
“Finally, a challenge that we are overcoming every day is that, although there are criteria to classify injuries, each person is a world. Therefore, we are trying to make our technology adapt to the needs and evolution of each user, both ergonomically and functionally. ”
Do you see the project implemented in Spain before any other country? Is Spain a good place to develop and carry out projects such as ABLE?
In the first, yes, we will start implementing our technology in Spain by knowledge of the environment (hospitals, rehabilitation centers, health system) and proximity, but our approach is global.
“And in the second, yes, too: we believe that Spain is a good place to start, although we still have to learn a lot from other countries. Barcelona is one of the most dynamic startup hubs in Europe. There is a solid ecosystem of Medtech and Biotech startups that, together with several incubators, accelerators and a great talent, are beginning to have their first success stories, which in turn is making the city and the sector more attractive to foreign private investment ”.
Is affordable robotics on the horizon?
I will tell you what it is, but this requires the joint effort of very diverse actors. First, from companies like ours to think about the costs in any internal process, from design and manufacturing to the selection of suppliers and marketing. Also to work hand in hand with referral hospitals and generate clinical evidence of the benefits of the use of robotics in rehabilitation. This requires initiatives such as those of EIT Health (European Institute of Technology) that promote synergies between startups and clinical institutions.
Over the years, we even expect exoskeletons to become increasingly economical and discreet.
"Only when more affordable products are obtained and there is evidence of the superiority of robotics over current clinical techniques, can a large-scale public refund be achieved, where health systems cover part or all of the cost of these devices."
“In addition, this is like a wheel, since, as the demand for exoskeletons in the medical industry increases, manufacturing costs are going to fall considerably. Thus, the sector is expected to change dramatically in the coming years: from just watching these devices on television or in the most advanced rehabilitation centers, to becoming something standard for the rehabilitation of mobility and, why not, in the daily assistance outside the hospital environment ”.
“We hope to see smarter and even more autonomous devices, with improved functionalities. Over the years, we even expect the exoskeletons to become increasingly discreet to the point of becoming even a fashion accessory that allows the user to use them continuously. ”
In addition to the Averis, what other prizes have been nominated? What have they won?
Yes, the project has received grants from EIT Health and the European Commission (H2020 SME Instrument Phase 1). We have also been selected among the most promising medical technology startups by MassMEDIC (Boston, USA) and by EU-Startups, and among the 10 most prominent in the field of medical robots by Silicon Canals. We obtained the first prize in the Richi Entrepreneurs (Boston, USA) and CRAASH Barcelona acceleration programs, organized by Biocat and CIMIT, the world's most successful health accelerator, and we were recognized as the Best Young Business Initiative (CECOT) .
ABLE Human Motion is developing its robotic exoskeletons to improve the mobility and autonomy of people who have suffered a spinal cord injury or stroke, and hopes to be able to market them from 2021. The current devices are expensive (approximately $ 110,000 dollars), heavy (20 kg) and require professional staff to use. ABLE expects to put on the market exoskeletons of about 8 kg. with a value not exceeding $ 10,000 dollars. We bet we will know about them in the very near future.
* The future vision to solve a problem of difficult treatment and the application of a cutting-edge technology make ABLE one of the best startups that have been included in our initiative "Tech for Change", a platform where both Digital Trends in Spanish as Digital Trends, projects and technological ideas that seek to do good and provide positive changes in society stand out.