How did you come up with the idea for your system?
König: I got the idea when I was working as a researcher in the United States back in 2013. I came across a publication that stated (and I am paraphrasing here): "Early mobilization in the intensive care unit is a wonderful idea, but we can't afford it because we don't have enough people for it. We need five staff members to facilitate this type of therapy."
Meanwhile, people had already received the therapy within the context of the publication. It comprised manual therapy that required both tremendous physical and financial resources. Yet the results were resounding. The therapy led to much shorter hospital stays, the duration of mechanical ventilation was shorter, and there were fewer secondary complications. This gave rise to the idea for our robotic technology.
What role does AI play in your equipment?
König: In the standard operating mode, the robot would assist the patient in performing an exercise. That means even if patients can perform the therapeutic exercise on their own, the robot would still follow its predetermined trajectory. The caregiver can make adjustments, though the patient has little to no influence on this process.
There are two elements here that benefit patients no matter their recovery stage. The first one pertains to the patients' active participation in their therapy. We aimed to empower patients to participate of their own accord, while the robot merely provides the right amount of power at the right time in the right direction to assist in the process. That is why we call this technology "Assist as Needed". It is an important factor because if I am actively involved in my therapy, the treatment will probably have an improved outcome.
The second factor pertains to patients with neurological disorders such as strokes, traumatic brain injury, and paraplegia. Here the aim is to generate the intention to move, which seems to be fundamental to the recovery. Many recovery processes are fueled by the patient saying, "I want to walk!" and then being capable to actually start walking. Many patients often want to move, and they may even generate a small motion, but it is not enough and doesn't amount to any actual movement. These are aspects the robot registers immediately. It subsequently provides the right amount of support in the right direction at the right time for the respective patient.
It means our intelligent technology adapts to the patient's abilities in real-time. It also makes continuous adjustments during therapy when the patient is getting exhausted or is tired and needs a break, for example. The device is therefore an intelligent, collaborative partner for physical therapists.
Do you have plans to improve your system or do you have other products in the works?
König: It's both, actually. Obviously, we continue to advance our existing system. I believe we can accomplish something no one else can. We can collect data on the current state of patient recovery. The hypothesis is that the more controlled and self-motivated their movements get, the better off they are. And the more they actively participate, the better the recovery process will be. We can provide a digital solution for this. We are very much driven by the concept of personalized therapy. That means building more data structures in this setting and maybe even learn from previous therapies and knowing that you have encountered a similar patient in the past and then suggest a comparable intervention paradigm. Individualized data-driven therapy is a big issue for us.
Our second approach is to venture beyond the intensive care sphere since movement is something that shapes all our lives. Movement means autonomy, which is what we want to encourage outside of the intensive care realm. That is why – among other things- we are working on a device for home use or home care settings to foster autonomy.
Last but not least, how did you like your MEDICA presentation?
König: It was very stimulating to be among people again. The number of technologies out there is truly impressive. It's so easy to create your own bubble, get stuck there and your work becomes all about the intensive care unit and therapy.
It is so important to visit trade fairs and get inspired by other medical fields and specialties. MEDICA is an outstanding forum to broaden your horizons! I was delighted to be out in the world again. And besides, Düsseldorf is always worth a visit.
