How Neofect is using wearables to change physical therapy

Every year more than 795,000 people in the US have a stroke, according to the Center for Disease Control. Even worse, strokes are the leading cause of long-term disability in the US, reducing mobility in more than half of stroke victims age 65 and up.

One of the primary ways to regain mobility lost due to a stroke is physical therapy, and Neofect, based in Burlingame, CA, is looking to use wearables to help make rehabilitation easier for those recovering.

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Neofect's solution is the Smart Glove, a wearable that almost feels like it drapes over your hand. You secure it to your wrist, with loops to hold each finger segment in place. It's got a hub that houses a 9-axis movement and position sensor, while each of the Glove's fingers has a flexible sensor that registers how much it's being bent.

All of these sensors are used by the Rapael Smart Rehab Platform to help power a variety of gamified rehab exercises, and Wareable got a chance to take the whole thing for a spin.

Each exercise is aimed at improving a type of motor function your hand is capable of: forearm pronation, which is twisting your forearm back and forth; wrist extension, which is moving your wrist up and down; wrist radial, which is moving your wrist side to side; and finger flexion, which is being able to both squeeze and open your fist.

The exercises themselves are simple games with simple graphics. They'll take you through a handful of routine tasks, like pouring wine or squeezing an orange or cooking an egg. The trick behind the Smart Rehab Platform, however, is that it learns as you're going. The better you do, the more challenging it can make itself.

Making rehab relatable

Rehab is a pain in the ass. Going to the gym is already difficult for a lot of people, but with physical rehabilitation you're relearning motor functions you had probably once taken for granted. Re-learning to walk or use your arm can be excruciatingly difficult.

Take it from me: I had to do light rehab, re-learning how to move my knee after getting hit by a car, and it was more difficult than any other workout I've ever done. It's strange to take something you once did unconsciously and essentially reprogram your brain to remember it.

Physical therapy is often not just something you do when you head to your therapist either, but something that is built off repetition, says Becky Pultman, a clinical manager at Neofect. The problem? People don't do their homework.

"A lot of times, at least I know from experience, when I work with a patient and I give them a home exercise program and they're using putty or just repetitive motions, they get bored with it," she says. "They don't necessarily want to do it."

Neofect is essentially trying to make rehab relatable. Patients will do exercises if they have a therapist pushing them, but when that motivation disappears something else needs to take its place. Neofect has chosen a variety of games, which are aimed at making the exercises relatable.

You're re-learning something you knew so well you barely thought about it

You can try it yourself to see the mental effect. If you hold out your hand and rotate your forearm to the left and right, you're just moving your arm about. Once you figure out that drying paint is more exciting, you'd stop. Neofect takes that motion and pairs it up with animations on a screen. All of a sudden that exercise you're doing is in the context of pouring a bottle of wine, which Pultman says makes it more motivational for patients who can see what each exercise will help them achieve.

It's a problem that people don't often realize what kind of motions result in basic abilities, like pouring something, says Scott Kim, CEO of Neofect. The Smart Rehab Platform also has another benefit: it lets therapists know if patients are actually doing their exercises.

Pultman says one issue that crops up between patients and therapists is that patients will often lie about doing their exercises (yep, I've done it too). This hurts the therapist's ability to gauge how much progress their patient is making and how they can help, Kim says.

"Using the measurable wearable device, they can be completely monitored," he says. "They can't lie about whether they did homework or not." It's not that people are lazy or aren't invested in their recovery, either. It's just that they get bored with doing difficult exercises at home, where distractions abound, says Pultman. Neofect wants to engage them.

From our use, Neofect's system is certainly engaging. This isn't Masterpiece Theater, but the animations and sound effects are oddly cute and enough to keep you engaged. After going through a full program, I didn't find my mind wandering a single bit.

The secret sauce is understanding

While in business school at the University of Virginia, Kim met his eventual co-founder and they began discussing ideas of things to do. One of their friends tried feeding them ideas, and then one particular story from him stuck with Kim.

"His father actually passed away from stroke and his family was not too wealthy so he didn't know about rehabilitation at home," Kim says. "He thought that 'if my father knew about this, it could have made some difference.'"

Kim himself was born with spina bifida, a disability where a neural tube fails to close properly and causes defects in the spinal cord. Much of Kim's own childhood was spent in rehab.

"I had fair share of rehab in my life," he says. "When I was a 6, 7, 8 year old kid I thought it was really boring and it was pretty painful when I had no idea what I was doing."

The three of them teamed up and got some funding from the South Korean government, putting together a rough prototype in 2010 of the Smart Glove and iterating on it in 2014. Much of the iteration was about getting it to be as light as possible for stroke victims.

Three years later, the Smart Glove is now available. You can buy it outright for $2,300, or you can get a two-year lease where you pay $99 a month. When you purchase the Smart Glove, a therapist like Pultman will walk you through how to do the exercises and help monitor your progress. Kim says the company still wanted occupational therapists to be the face of the product as they're better at interacting with people than a tech company is likely to be.

The Smart Glove isn't where Neofect is stopping though. The company also makes a smaller version for kids, as around 3,000 children have strokes every year in the US.

Beyond strokes, Neofect is looking to expand to other devices. Its newest device, the Smart Board, allows you to check the range of motion for your shoulder. Kim says Neofect eventually wants to bring its wearable technology to lower body parts like knees and ankles, though those plans are still in the early phases.

The most important bit that Neofect understands is that it can't fully replace physical therapy with an occupational therapist. It's a way to improve the take-home portion of rehab. "What all the studies have shown is that we need to be doing them side by side," Pultman says. "It's not going to work if you're just doing this or just doing therapy. This kind of enhances the therapy."