In the UK, there are an estimated 187,000 children living with an arm disability, and 85 million worldwide. Without regular occupational therapy for upper limb and hand strength, dexterity and movement range, a child’s condition is likely to deteriorate and impact their ability to live in functional independence in adulthood. Many arm disabilities are linked to neurological disorders, such as Cerebral Palsy, which affects coordination, precision, and timing of movements.
GripAble, who are familiar faces in the field of rehabilitation devices, have teamed up with Dr Firat Güder’s team from the Department of Bioengineering at Imperial College London to develop a product called SqueezAble. They have been awarded a grant by the Biomedical Catalyst (BMC) Feasibility and Primer Awards 2021 competition, which was run by Innovate UK to support UK registered businesses to develop innovative healthcare products, technologies, and processes.
GripAble
For those that are not already aware of the GripAble device, it is a smart mobile assessment and training device that connects to an app, to help people with upper limb movement impairment to improve movement and grip strength. The device itself is a handheld device that is gripped by a user and includes a bar that can be depressed when a user squeezes their hand into a fist. Sensors in the device transmit data measured when the user squeezes their fist to the companion app.
As a neuroscientist carrying out his PhD at Imperial College London, Dr Paul Rinne (Co-founder and CEO of GripAble) was working closely with therapy teams on stroke wards. The need for an accessible mobile device for patients undergoing physical and occupational therapy soon became clear. Traditional therapy equipment – like foams, cones and putty – wasn’t cutting it and couldn’t provide real-time motivation, feedback or data for tracking progress, leading patients to become disengaged in their rehab regimes once unsupervised.
“We all know how hard it is to keep exercising; imagine having to exercise every single day after suffering a life shattering event like a stroke. Performing hours of the same repetitive movements every day, just to be able to feed yourself, hold a glass of water – or hug your loved ones again.”
— Dr Paul Rinne, Co-founder and CEO, GripAble
The technology behind the GripAble system was developed by Dr Paul Rinne and Dr Mike Mace (Co-founder and CTO of GripAble), who received their Doctorates from Imperial College London before founding GripAble.
To tackle the challenge of maintaining user engagement, the companion app for the GripAble device gamifies the rehabilitation process by providing interactive activities to be completed by the patient on screen. The manual manipulation of the device acts as the controller for the game and the games can be designed to encourage a certain type of input, such as smooth squeezing and releasing of the device, in order to achieve certain therapeutic goals.
The GripAble system is currently used by neurological and orthopaedic therapists in hospital and community settings across the UK.
SqueezAble
The SqueezAble device builds on the GripAble concept by providing an interactive gamified rehabilitation process with soft-sensor technology developed by Dr Firat Güder’s team at Imperial College London. The soft-sensor technology is currently patent pending.
Where the GripAble device originally focused on enabling physical therapy exercises to be conducted with one hand/arm at a time, also referred to as unimanual exercises, the SqueezAble device has been developed to enable the training of bimanual hand function. The need for children living with arm disabilities to learn to independently complete bimanual activities, i.e., using both hands simultaneously, to complete tasks such as eating, writing, and washing was a leading motivator in this new development.
Currently, bimanual function is trained, or rehabilitated, using soft therapy tools such as a stress ball and putty; however, SqueezAble, proposes to digitize these soft therapy tools to provide the benefits of user engagement already proven with the GripAble device.
The Squeezable project team intend to work with children with cerebral palsy to develop SqueezAble. Dr Güder has said:
“This project will allow us to build a medical device and an entirely new concept to address a large gap in current practice, which we hope will be especially valuable for the rehabilitation of paediatric patients.”
Conclusion
The solutions proposed by GribAble provide a rehabilitation device with a direct feedback mechanism in the form of an interactive game controlled using the rehabilitation device. The benefit to user engagement, especially with paediatric patients, is clear and the device can also coach the user to perform the exercises correctly. This means a user can be left to perform the exercises without continual supervision or use the system from the comfort of their own home.
It is always exciting to see developments such as these in fields that have been relying on the same tools for a long time. It will be interesting to see if these concepts can be applied to different forms of rehabilitation in the future.
