The concept of three people living with complete paralysis regaining the ability to walk independently is something that, in the very recent past, would have been dismissed as being impossible – but through the work of ONWARD, this one-time ‘impossibility’ is now becoming reality.
For years, spinal cord injury has been regarded by many as the ‘graveyard of neuroscience’, where hope was in short supply and the outlook for those daring to dream of the day that may change was bleak.
But now, through the efforts of pioneers who have led the research breakthroughs that are now shaping reality, the ability of technology to change lives is being seen by the whole world, with people watching in amazement as paralysed patients rediscover the ability to move.
After being implanted with spinal stimulation technology developed by ONWARD – the first time its epidural electrical stimulation (EES) had been trialled in humans – all three participants who were part of the STIMO-BRIDGE trial were able to take steps independently within a single day.
After five months of rehabilitation, they were also able to use their legs to stand, walk, swim, and/or cycle. They also regained control of their trunk muscles.
Such colossal steps forward in SCI are now giving new hope to people living with paralysis – and are helping to show, rather than being impossible, what could become the new possible for the future.
“We were very pleased with the results of STIMO-BRIDGE, although we as a company are not going to be pleased with just impacting subjects in a clinical trial,” Dave Marver, CEO of ONWARD, tells NR Times.
“Our job and our unique role is to scale these therapies so they can provide benefit to hundreds of thousands of people with spinal cord injury around the world.
“These results show great promise, but we still have a tremendous amount of work to do to achieve our vision.”
And for ONWARD, that vision is to change the lives of people living with SCI globally, to enable them to enjoy and live their lives in the ways that matter most to them.
Established in 2014 to focus specifically on SCI, the venture has led truly groundbreaking research into this long-underserved area.
Founded by neurosurgeon Dr Jocelyne Bloch and Professor Gregoire Courtine, Swiss-based ONWARD has taken decades of research and translational science to bring to fruition two viable commercial solutions.
With its ARC EX and ARC IM devices, ONWARD – backed by many of the leading European life sciences venture capital investors – has led the charge on redefining the outlook for SCI patients.
Its ARC IM, recently subject to the STIMO-BRIDGE trial, consists of an implantable pulse generator and lead that is placed near the spinal cord, controlled by wearable components and a smartwatch. A pivotal trial is set to begin within the next 12 to 18 months.
The ARC EX is an external, non-invasive wearable stimulator and wireless programmer, which targets the rediscovery of upper body movement. Currently subject to the international Up-LIFT trial – the largest SCI trial of its kind – it completed enrolment of 65 participants ahead of schedule, despite the many challenges presented by the COVID-19 pandemic.
Currently being trialled at sites across the world – including in the NHS Greater Glasgow and Clyde (NHSGGC), as well as Neurokinex sites in England – the aim, pending necessary approvals, is for a commercial launch in the first half of 2023.
But while the excitement at the potential of ONWARD is palpable, with the first introduction of its technology into rehabilitation centres across the United States, UK, France, Germany and the Netherlands potentially barely a year away, Dave is keen to ensure expectations remain realistic.
“Certainly this will give hope to people, and I think the fact we enrolled all 65 subjects in Up-LIFT ahead of schedule, despite all the challenges of clinics closing and difficulties with quarantines and so forth, speaks to the enthusiasm that the clinical community has for this therapy,” he says.
“They have really embraced it, as the participants did in STIMO-BRIDGE. We, and they, are showing what is possible.
“But I do think it’s important to not overstate it, I don’t want to create false hope, because these subjects really committed themselves to the therapy and to the rehabilitation process.
“I think there is great potential that many people with paralysis will be able to stand again with the benefit of our therapies, maybe take some steps. But then it really depends on their particular circumstances and their overall level of health, their willingness to commit to rehabilitation, whether they can go further than that.
“And, of course, not everyone with spinal cord injury, desires necessarily to walk again, they may have other priorities. And that’s why ONWARD is also committed to addressing other challenges that affect the quality of daily life, such as blood pressure and trunk control and use of better use of the upper extremities.
“And then in the future, we’ll be looking at incontinence and restoration of sexual function, the whole battery of things that people with SCI have to contend with.”
Through its longstanding and deep-rooted commitment to the SCI community, ONWARD has secured relationships with of some of the world’s leading organisations in this area, including the International Spinal Research Trust and the Christopher & Dana Reeve Foundation. The latter has even become ONWARD shareholders, to help further its pioneering work.
For Dave, while the word ‘pioneering’ is well-used, for ONWARD, it is also well-earned.
“I think we are seen as pioneers in this area because we’ve chosen to focus on serving the spinal cord injury community,” he says.
“It’s a smaller population than other populations with movement-related challenges, like stroke and Parkinson’s, for example. Most businesses orientate toward the largest potential markets, whereas our founders really had a passion for helping people with spinal cord injury.
“And that remains the core vision, that was their raison d’être, and it’s with that commitment and determination that we have achieved such progress.
“We haven’t partnered with existing spinal cord stimulation companies, we’ve developed our own technology platform that is built for the specific purpose of not stimulating the spinal cord for pain management, but stimulating the spinal cord to restore strength and function.
“But I think the progress we have made also reflects the close collaboration that we enjoy and value with our scientific partners. We have a group of people so committed and driven by our mission, which I think is why we make the progress we have done.
“We develop that lead together in a very rigorous way, with our vision at the heart of that.”
Constantly looking to the next innovation and how its technologies can be even more beneficial to those who need them, ONWARD is also considering how, post-commercial launch, its ARC EX could be used remotely.
“Later, we’ll be seeking approval for it to be used in people’s homes, so they can conduct periodic sessions maybe once or twice a week in their homes to continue gains that they have observed in the clinic, and build on those gains,” says Dave.
“We’ll be looking at a successor study to Up-LIFT which would look at safety and performance when used in the home.
“Without question, it’s important with spinal cord injury to be able to operate this technology, which is why we were keen to incorporate voice activation into the system. Both of our platforms can be programmed by the clinician, but in the future may be operated by and used by the injured with their voices.
“But very importantly, we do our best to connect as frequently as possible with people with injury to inform the design of our product platforms, and inform our future direction as a company.
“We consider ourselves part of the community, so that feedback to ensure the design of our technologies is really usable and accessible, in my view, is vitally important.”
And with such huge advances and new-found hope for the future, many conversations have turned to whether SCI may be curable.
“I wouldn’t rule anything out, with human ingenuity and so forth, but what I would say is more realistic at this point is to have optimism – quite a bit of optimism – that movement and strength and function can improve, and in some cases, be restored with the benefit of therapies like ours,” says Dave.
“Perhaps other therapies and technologies will emerge, if you look at how far we have come. But for us, our vision is to support the SCI community around the world through our therapies, and we’ll continue to do that.
“We’re making steady progress across all areas of our plan, and while what we’re doing is difficult and complex, I’m confident we will come through.”
Fourier Intelligence continues international collaboration
The rehab robotics pioneer has signed a MoU with Centro Europeo de Neurosciencias
Rehab robotics unicorn Fourier Intelligence is continuing its work in advancing the fast-growing sector by forming a new partnership with Centro Europeo de Neurosciencias (CEN).
The signing of the Memorandum of Understanding (MoU) will focus on the testing of new and existing rehabilitation robotic devices created by Fourier Intelligence.
Fourier Intelligence robotics are already in use around the world, with testing and feedback undertaken continually to ensure they are best equipped to improve patients’ lives and deliver the highest standards of rehabilitation.
With a track record of healthcare excellence and research, working alongside international partners, CEN already makes an important contribution on a global scale and will be a key partner in the further development of Fourier Intelligence’s portfolio of life-changing devices.
The MoU is the latest to be signed by Fourier Intelligence with key global partners, as part of its commitment to working in collaboration with experts around the world to create world-leading rehab robotics.
“The agreement of this MoU is another significant step in the ongoing development of rehabilitation robotics, which will improve patients’ lives,” says Zen Koh, co-founder and group deputy CEO of Fourier Intelligence.
“CEN has an excellent international reputation and track record in healthcare and research, and we are delighted to partner with them in this way. The testing of new and existing Fourier Intelligence devices is critical to maximising patient outcomes, so this will be very important in achieving that.
“We believe collaboration is at the heart of developing this sector and making a difference in the lives of those who need this technology, and are very proud to have key partners around the world. Together, we will take this forward and make the positive change that is needed.”
The patience of patients
Stroke survivor Lisa Beaumont reflects on her ongoing rehabilitation and the vital role NeuroProactive can play
Rehabilitation cannot be rushed. Each patient needs to develop techniques to build the patience they need.
In Spring 2022, I faced the biggest setback in my rehabilitation journey so far. A problem with my leg splint meant that I was unable to walk for two to three months.
I learned plenty about myself during this interlude. While my orthotic was being replaced, I watched from my window while Spring became early Summer. I could not leave my bedroom for several weeks. Most importantly, I learned about my techniques for managing my frustration with my situation.
I had plenty of time to reflect upon my situation and to consider ways that might avoid this situation happening for others. Access to digital solutions such as neuroproactive.com from the outset will offer solutions for the patients of the future.
For the last eleven years I have focussed my energy on learning to walk again. Therefore, it took a substantial adjustment physically and mentally for me to adapt to being confined to one room without any possibility of walking anywhere. I chose to focus on two activities which were possible for me to do.
Firstly, I could still develop my cognitive rehabilitation through game-playing. I found several games I could play on my phone, including Wordle, Words with Friends and Solitaire.
I realised that Solitaire, also known as the English card game Patience, makes a good analogy for any rehabilitation journey. There is only one player in the game, and you can win or lose depending on your actions and choices. You cannot speed up the pace of the game, but you at least know where you are.
Likewise, in rehabilitation. Neuroproactive.com offers features that would have avoided some of my frustration this Spring. It enables speedy communication between clinicians and patients. I would have had an opportunity to track the progress of my replacement splint. And it would have been a single place for the orthotist, physiotherapist and district nurses to discuss my case.
I realised that a strength of neuroproactive.com is that it recognises the central role that a patient has in their rehabilitation journey. Consequently, the platform validates the patient’s experiences by giving them the ability so see and to help manage the input they need from their team of clinicians.
The other second activity was that part of the physiotherapy that I could still do – exercises in bed and upper limb work. My carers supported me by helping me to count and record my repetitions and by monitoring the quality of my movements.
How could neuroproactive.com have helped to improve my situation? My situation could potentially have been avoided through better
communication between my orthotist, physiotherapist, GP and my team of carers. Neuroproactive.com can act as a single shared space for each person to share updates and photos.
As more practitioners gain access to, and familiarity with, Neuroproactive.com and its features, new and exciting ways to use it will emerge.
We’re in the process of rolling out Neuro ProActive to 31 NHS Trusts.
You can find out more online www.Neuroproactive.com or connect with us on Twitter @NeuroProActive.
Fourier Intelligence: ‘All eyes are on us now’
‘We are ready to lead, collaborate and change people’s lives,’ says Zen Koh
Now firmly established as a leader in its field on an international scale, Fourier Intelligence has again captured the world’s attention through attracting a second major investor to support its pioneering work in rehab robotics.
Here, deputy chief executive Zen Koh tells NR Times how the business is now ready to unite and lead the sector, and be a force for good in global tech
Having emerged as a leader in the field of rehab robotics on a global scale, Fourier Intelligence continues to push the boundaries of what is possible in technology.
With a track record of designing and creating robotics which truly redefine the outlook for patient rehabilitation – and its most recent launch of the ArmMotus™ EMU being hailed as being capable of redefining neurorehab as we know it – its latest creations are set to up the ante even further.
With the impending launch of the MetaMotus™ system, and its fully immersive gait training Galileo model – its first to make use of its move into world-leading standards of VR technology – Fourier is moving forward day by day in its quest to improve patients’ lives; an ambition the business has had as its focus from day one.
And to accompany the unveiling of its latest technology, Fourier is set to leave the world in no doubt of its capability by creating the world’s first bionic robot.
The globally sought-after ability to create a ‘virtual human’ – which tech powerhouses and entrepreneurs, including Elon Musk, believe lies at the future of human operation – would show the scale of Fourier’s innovation and underline its ability to create cutting-edge technology beyond the world of rehab and healthcare.
Attracting investment to the sector
But within the healthcare sector, where it has become established as a true pioneer, Fourier is now known as a force to be reckoned with, having become the first rehab robotics business to attract two major mainstream investors – Saudi Aramco, which made a significant investment last year, and SoftBank, which led a RMB 400million in a Series D funding round in early 2022.
For Zen Koh, deputy chief executive and co-founder of Fourier Intelligence, this investment will help unlock the next stage of growth for the business, which includes ongoing international collaborations, and is set to include its first acquisitions.
“The investment will definitely speed up the whole process and accelerate the pace of expansion,” says Zen.
“We have grown organically and steadily and this is a great boost. It is more ammunition for our plans and also gives us the option to look at more options.
“We are recruiting many new people to set up and grow teams in Europe, Australia and the US, and are also looking at acquiring companies. We are already talking to a few companies across North America, Europe and Asia. Some of these companies have been doing great work for 30 years or so, so to bring them together would be positive for this whole sector.
“But it’s not just the technology we need – it is the teams, the really experienced managers. It is very challenging to find such people who are trained and accomplished in product management, development, R&D, sales, all aspects of running a company.
“Through acquisition, this will help us run faster, strengthen the team, and is a brilliant opportunity for us, which has been made possible by the investment.
“We are big believers in collaborating, not competing, and there are a few small companies who are competing with each other, but they are too small on their own. We are excited to see where this goes – everyone is looking for a leader in this field to help take us all forward.”
Ready to lead by example
And with the rapid expansion and unrelenting ambition of Fourier, there can be few better placed than the business – which has recently relocated to the Silicon Valley of the East in Shanghai – to take on that mantle.
“I think there is definitely an opportunity for us to take a lead on a global scale,” says Zen, the incoming president of the International Industry Society in Advanced Rehabilitation Technology (IISART).
“In 20 years working in health, I have seen many companies come and go, but we have managed to sustain our success.
“In spite of what has happened with COVID, the business is exactly where we want it to be. Instead of slowing down, we have speeded up, and investors believe in our dream. These are major mainstream investors, we are playing in the top league now.
“I was speaking with a friend, who is a very experienced individual in this area, and he said he is sure Fourier are now in a position to take control of the market. I see that as a huge vote of confidence in what we are doing.
“Fourier will do the right thing and raise the flag high in this industry. We will lead us all in working together to a future where we are helping to make a difference to people’s lives.
“But when you reach that milestone, to quote Spiderman, ‘With more power comes responsibility’. We appreciate that when you are big enough, you should ‘do well and do good’. All eyes are on us now but we are on the right track, the track we want to be on.”
Improving lives through technology
But while its presence in rehab tech continues to make waves internationally – with partnerships in place with fellow world-renowned names in neuro-rehab, including the Shirley Ryan AbilityLab – Fourier’s capability is now seeing it look at how to improve people’s lives in general, beyond the field of rehab.
“Our slogan from the start has been ‘Empowering You’, which means through technology and health solutions, but also through research and education and other applications outside rehab,” says Zen, who co-founded Fourier with Alex Gu.
“Alex and I are engineers who have worked in robotics since graduation, and this is very exciting for us. Healthcare has been our initial application but we are looking at other areas. The launch of the bionic robot is going to move things to another level.
“In terms of what we have already, we are looking to extend our EXOPS™ system (the Fourier Exoskeleton & Robotics Open Platform System, which delivers education to help accelerate the development of rehab tech opportunities) and will encourage more people to adopt it, to make that application available outside of rehab.
“VR is a strong area for us and the launch of Galileo is going to be very exciting, it’s going to be huge, not just as a product but in showing what we can do.
“We are making major advances in technology and now have the freedom to go beyond healthcare in applying that.”
Today’s investment creates tomorrow’s talent
As a business on a path of strong global growth, while being acutely aware of its responsibility as a leader, one area in which Fourier is keen to make a difference is in creating tomorrow’s talent. Opportunities are being created around the world for aspiring young engineers and developers, and partnerships have been formed with a growing number of leading academic institutions.
“Existing knowledge can never be enough in this industry. We are always advancing and with that, we need the talent to enable this development,” says Zen.
“We are working with some of the leading researchers to create joint labs, we offer scholarships for PhD students with the Shirley Ryan AbilityLab and University of Melbourne. We want to continue to partner with universities to offer the highest standards in continuing education.
“The MotusAcademy (founded to enable ongoing professional development in advanced robotics rehab tech) will offer a research platform and will help to lead this further, with the highest standards and results.
“We can never think what we are doing is good enough, as we can always do more. The world is advancing, and through knowledge, we can continue to advance.”
- News4 weeks ago
Think Therapy 1st set for future through leadership change
- Spinal3 weeks ago
Walton Centre secures Centre of Excellence spinal status
- Spinal3 weeks ago
NeuroAiD shows potential in spinal cord injury recovery
- Therapies4 weeks ago
How visualisation can support emotional wellbeing
- Tech4 weeks ago
THERA-Trainer develops revolutionary music tool
- Inpatient rehab4 weeks ago
‘Getting the foundations right is a platform for growth’
- Brain injury4 weeks ago
Breath test could detect repetitive blast injury
- Tech3 weeks ago
Fourier Intelligence: ‘All eyes are on us now’