Robots assist physical rehab

In 2003, Israeli engineer and robotics expert Omer Einav received a call out of the blue from a headhunter.

Two entrepreneurs, the caller said, were looking to invest in robotic medical applications. Did Einav have any ideas?

Einav, whose previous experience was in the automotive and electronics industries, did not, but he promptly started reading up on medicine to come up with some. Soon, he and the investors had settled on an area he thought was ripe for such technology: physical therapy.

The need for highly repetitive, labor-intensive movements made it a natural fit for robotics. And the aging of populations in the industrialized world, coupled with shortages of health-care workers, would create a large potential market.

By 2004, Motorika Ltd., whose U.S. headquarters is in Mount Laurel, where it employs eight people, was born. It is currently experiencing a growth spurt.

Motorika's Reo Go, a device for patients with disabling arm problems, was introduced in the United States last year and is now in use in 12 hospitals, including MossRehab in Philadelphia and Good Shepherd Rehabilitation Network in Allentown. A handful have been sold in Italy, and the machine is approved for sale in the rest of the European Union, said Einav, Motorika's chief operating officer.

A Japanese pharmaceutical and medical-device company, Teijin Pharma Ltd., is partnering with Motorika to sell the Reo Go next year to rehabilitation facilities in Japan and to market a smaller home version of the machine the following year in Japan and the United States.

Teijin estimates it can sell 10,000 home robots in Japan within three years, Einav said.

The list price for the Reo Go is $65,000 (early adopters have paid less), and the home product will likely sell for less than $10,000, said Rich Mahoney, Motorika's general manager.

In what Mahoney calls "the next leap for us," Motorika also recently reached an agreement with HealthSouth Corp., a health-care-services provider that had $3 billion in revenue in 2006. Motorika will take over the sale and manufacture of the AutoAmbulator, a robot-assisted therapy system for the lower body developed by HealthSouth and used in more than 85 of its rehabilitation facilities. HealthSouth has also agreed to buy 25 Reo Goes by the end of next year.

The two companies have agreed to integrate their technology platforms, collaborate on research, and develop products for the home.

Dexanne Clohan, HealthSouth's chief medical officer, said the partnership grew from Motorika's efforts to sell some Reo Goes to the corporation. "Both parties started seeing the synergy," she said.

Both the Reo Go and AutoAmbulator are based on the idea that highly repetitive activities can help people who are disabled because of stroke or other neurological problems to establish new pathways in the brain or strengthen the old, damaged ones. It is the equivalent of finding your way around a roadblock. The robotic machines help patients perform an action, but gradually provide less and less assistance as the devices sense that patients are capable of doing more on their own.

Clohan said Reo Go's software keeps better records than the AutoAmbulator of how patients are progressing, a useful tool for research.

She called the AutoAmbulator a "quite wonderful and unique device," but said the development and manufacture of machinery was "not fundamentally our core business."

The $90,000 machine helps people who have trouble walking improve their gait. They are suspended in a harness above a treadmill. Robotic arms help propel their legs.

The machine does the work of three therapists and is better at duplicating a natural gait, Clohan said.

Motorika has two years' worth of production orders for HealthSouth facilities, Mahoney said. After that, it will work with HealthSouth to determine who else in the United States will have access to AutoAmbulators. Motorika has the unrestricted rights to sell them in the rest of the world.

The Reo Go allows patients to work one arm at a time with a long joystick. They move their arms in patterns chosen by a physical therapist and displayed on a computer screen.

Einav is especially proud of the machine's easy setup - it takes only a minute, he says, to switch from one patient to the next.

Lisa Werner, a physical therapist at Moss, said her patients loved the machine. They are able to do more repetitions of an exercise, and it frees her up to focus on other things, like posture. The interactivity makes it feel "almost like a game."

Initially skeptical, Werner said, "I like it much more than I thought I would."

Sue Golden, director of neurorehabilitation at Good Shepherd, said her system had been using its three machines for stroke, head-injury and spinal-cord-injury patients. Some patients have had marked improvement in their range of motion and pain after just one session.

The hospital wanted to try the device because "we as an institution have made a commitment to looking at technology in a lot of different spheres," Golden said.

The machine is better than people at some things, but not cheaper, she said. "I'm looking at what is it going to accomplish clinically that we with our hands have trouble doing?"