Eyes on the Future: A Hand to Hold - How Soft Robotics are Changing the Game in Neurorehabilitation

Stroke is one of the leading causes of physical impairment. According to SingHealth, between 25 to 40 percent of stroke survivors suffer minor to moderate impairments. Other causes of neurological system damage that affect the use and mobility of the hands include cerebral palsy, traumatic brain injury, and injuries to the hand.

Not so long ago, if one suffered from neurological damage to the hands, the rehabilitative options were costly and confined to the hospital or clinic in which the therapy was administered. This limited patients’ access to the frequent treatment required to bring noticeable improvements.

This all changed in 2016 with the founding of Roceso Technologies, a medical device start-up based in Singapore, which created the EsoGLOVE. Roceso is the brainchild of Jane Wang – its CEO – and co-founders Dr Yap Hong Kai (CTO) and Dr Raye Yeow (Scientific Advisor).

It marks a full circle in Jane’s career. When she was younger, she dreamed of attending medical school to help others and create a positive impact on their lives. 

However, a scholarship to study engineering changed all that. Her last stop before starting Roceso was as a management consultant. As it turns out, both her academic training and career in consulting would play a huge part in her design, innovation, and entrepreneurship journey.

Hand in Glove

As the company’s signature product, EsoGLOVE propelled Roceso to global prominence and made it a leader in medical devices for neurological solutions. Its use of soft robotics has given therapists new tools to enhance treatment efficacy to improve a patient’s rehab and recovery.

With Roceso’s initial technology, the company conducted over a hundred interviews with healthcare professionals, patients, and other parties before identifying a gap in the healthcare market for neurorehabilitation solutions.

Most existing treatment plans focused on the lower limbs, with less attention on finer motor movements.  The founders’ strong inclination to help patients regain the use of their hands fuelled their venture.

The introduction of EsoGLOVE has provided patients and their families a ray of hope in being able to use their hands again, and in the process, restoring their independence and dignity.

As its name suggests, EsoGLOVE is a wearable hand rehabilitation device made from lightweight and flexible fabric, which allows patients to comfortably perform high repetition motions to aid recovery of the affected hand.

EsoGLOVE works by creating neural pathways in patients through repetition and retraining. This trains healthy brain cells to take control of fine motor movements in the extremities. 

In a rehabilitation centre setting, EsoGLOVE assists therapists with intensifying rehabilitative treatment on the patient and affords a longer period of training with minimal supervision. The accompanying software offers multiple exercises, further allowing therapists to conduct personalised therapy based on the patient’s clinical requirements.

This system is designed to allow patients to carry out upper-limb rehabilitation with multiple training modes, such as passive mobilisation, active-assisted range of motion, and bilateral training.

While there are other exoskeleton devices on the market today, EsoGLOVE differs through several unique features not found on similar devices.

These include incorporating both Functional Task-oriented and Intention-driven Active Training together with Action Observation Therapy. Additionally, its high intensity capabilities mean that it can generate 300 repetitions per hour. At just one kilogram, it is a highly portable system that takes less than three minutes to set up.

The Road to Recovery

Roceso is a portmanteau of robotics and Aceso, the Greek goddess for healing, which is apt given that the company is in the business of using soft robotics to help patients recover their mobility.

EsoGLOVE is a boon for patients and their caregivers and has been well-received by the medical community. It is used by both hospitals and clinics and is sold in more than 30 countries worldwide.

The availability of the gloves as home rentals also reduces inconvenience for patients, especially those who are wheelchair-bound and elderly.

At home, patients can use the glove more regularly, thereby increasing chances of recovery in a shorter amount of time. Such patients have seen significant improvement in spasticity reduction, gripping strength, as well as muscle signals.

The company adds that generally, most patients see improvements after one to two sessions. That said, they still need to keep going for weeks to months to see sustainable progress and prevent regression.

Another tool in Roceso’s repertoire is the use of gamification which can significantly improve patient engagement and treatment outcome. Gamification does more than add variety to the rehabilitation sessions. It also encourages patients in the treatment process, which can be frustrating and monotonous. Patients often experience depression because of their conditions, so gamification can add an element of interest to treatment. 

Together with therapist assessment, gamification data is stored and analysed with Roceso’s platform technology, eventually helping to enhance treatment productivity and efficacy.

Where You Plant Your Seed Matters

When Jane and her co-founders were looking for a place in 2016 to house Roceso’s office and R&D facilities, it made sense for them to find a location in close proximity to the medical device and neurorehabilitation ecosystem.

Being near to partners like the National University Hospital System and Alexandria Hospital makes it convenient to conduct clinical trials. The accessible location is also important in attracting and retaining talent.

Jane shares that it did not take them long to decide on CapitaLand’s Singapore Science Park: “It had everything we needed as a start-up, plus the flexibility to enable us to expand and scale up quickly. CapitaLand was keen on locating value chain players within The Curie, and we felt they shared our potential for Roceso.”

One benefit Roceso has enjoyed is securing their place in the Singapore Science Park and one-north community, Singapore’s prime biomedical hub. Here, Jane remarks that Roceso can share ideas with other businesses. 

Though the nature of other tenants’ businesses may be different, they often face common problems. Being able to conveniently meet or visit each other to share, discuss or collaborate is not something easily replicated if Roceso were located elsewhere.

Jane also highlights a unique feature of CapitaLand: “While The Curie offered us the hardware to meet our spatial needs to perform our R&D and house product assembly lines, we also appreciated that CapitaLand as a landlord is proactive in engaging tenants and creating opportunities for tenants to meet, including in social settings.”

The Future Pathway for Roceso Technologies and Neurorehabilitation

While EsoGLOVE is Roceso’s flagship product, the company has also developed a suite of integrated solutions.

In April 2022, it launched its clinical arm, the Cygni Advanced Neurorehabilitation Centre. The technology-driven space is the first such facility offering world class upper limb occupational therapy programmes in Singapore. It implements cutting edge technologies specialising in post-stroke recovery rehabilitation and dementia care.

The Centre aims to bridge the gap of accessible therapy after hospital discharge with a personalised plan and space for clients to embark on their recovery journey.

By the first half of 2023, Roceso will launch Dyna-X GLOVE – designed to aid neurological and orthopaedic conditions in achieving optimal finger and thumb movements through a patented fabric spring technology. 

What does the future hold for Roceso, and where is neurorehabilitation headed? According to Jane, the trend in neurorehabilitation is headed towards the involvement of robotics, technology, and sensors. In the past, it was very manual and labour-intensive.

“What we’ve learnt from the Covid pandemic is the need to have more technology deployed, both to deal with contactless rehab to minimise disruptions to patient treatment, as well as to overcome the shortage of therapists,” she shares.

To her, the key to enhancing treatment efficacy and patient access is for the devices to be even smaller and more portable. This will help adapt to smaller rehab spaces and the shifting of non-critical medical treatment  to home-based arrangements. Patients will benefit too as such solutions get more affordable and convenient.

With its devices already leveraging soft robotics and tech-enabled support and assessment, Roceso is moving a few steps ahead of the curve by deploying intelligent devices, enhancing therapist-patient interaction through its platform technology, and leveraging cloud connection to track and share patient data for treatment continuity.

In the not-too-distant future, she believes neurorehabilitation will evolve towards greater use of digitalisation – tele rehab will eventually become possible and enable high intensity recovery at home.

Machine learning and AI will enable less reliance on human therapists with the use of data analysis and adaptive engines. These technologies are poised to improve productivity significantly.

Roceso Technologies is not only leading the revolution in neurorehabilitation solutions from their premises at Singapore Science Park. They are also helping hundreds, if not thousands, of stroke survivors and sufferers of upper limb impairments caused by neurological damage across the world lead more independent and dignified lives. 

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