A New Approach to Parkinson’s Disease: How Robotics Can Help

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Developing wearable devices that help Parkinson's patients

There are many insidious diseases that debilitate people, but one of the worst is Parkinson’s. Its level of importance has been highlighted by celebrities including Michael J. Fox and Mohammed Ali, who recently died from complications from the disease. About 60,000 people a year are afflicted with Parkinson’s, and an estimated 7 million to 10 million people around the globe are living with it. Alfredo Muniz and Sade Oba are seniors at the University of Pennsylvania who hope their research in robotics will help improve the quality of life for those living with the disease. They are looking at the effectiveness of using motion sensors to gather data and have founded a company called Xeed. They recently spoke with the Knowledge@Wharton Show on Sirius XM channel 111 about their work and how it can be applied.

An edited transcript of the conversation follows.

Knowledge@Wharton: Where did the idea come from to gather data on Parkinson’s disease?

Alfredo Muniz: It actually came from a robot. We’re both also roboticists master’s students here at Penn, and it actually started from a robot that could do anything. As amazing as that sounds, no one wanted to buy it. You could think of it as a mobile Amazon Echo. After a good half a year or so of trying to commercialize it, we realized that it wasn’t going to happen. No one wanted this amazing robot because the Amazon Echo was already out.

So we took some sensors in the robot and used them for a different purpose. After talking to a couple of people, we realized that [the sensors] could really track fine motor movement very well. After just a very quick conversation with a physical therapist, we focused in on movement disorders and then focused in even more on Parkinson’s disease. This community is really, really hungry for a new way of tracking the disease, and that’s where we hope that our company comes into play.

Knowledge@Wharton: You had this idea of using a trackable, wearing device. What’s the next step in the process?

Muniz: During our studies with robotics, we realized that if you have a robotic arm, you can make it do anything. The idea is nothing new. People have tried to make human robotic arms. We’re just using the same principles, but without the hardware. So this is actually the tracking part. Now we have prototypes, so we have an order coming in from China that’s about 100 different sensors and we’re going to beta test them with our communities here in Philadelphia.

“This community is really, really hungry for a new way of tracking the disease, and that’s where we hope that our company comes into play.”

Knowledge@Wharton: How quick of a process has this been?

Sade Oba: It was fairly quick. We’ve been working on this for a little over a year, but the transition from a robot to an actual wearable was about a two-month process. It was a realization of, “OK, we need to use only a few sensors, we need to make a wearable, let’s go.” Fortunately, we had had enough experience in our past internships doing product design or bio-wearables to be able to come up with a really quick prototype and iteration to start presenting to people.

Knowledge@Wharton: You mentioned talking with a physical therapist. I’m guessing that you’re getting more interest these days from the medical community?

Oba: Yes. We formed a new partnership with Dr. Alice Chen-Plotkin, assistant professor of neurology at the Perelman School of Medicine at UPenn, who has a small group of 250 Parkinson’s patients who will be able to test our devices, which is great. We’ll get a lot of good feedback.

Knowledge@Wharton: What is it that doctors hope they will be able to gather from tracking all that motion?

Muniz: She’s really interested in the effectiveness of medication and the kind of treatments that she has. She has space at the Penn Tower, and she wants us to participate in this kind of trial where she’ll bring in different patients and have them wear the device. These rooms are videotaped. The patients will be there for a couple hours each day, and we’ll basically monitor them. The doctor will say, “Is the drug working? Are you dyskinetic? Is the drug off? Do you need to take medication now?” We’ll be tracking that with the data from the wearables. With that and a little bit of machine learning, we’ll be able to hopefully map that to even more people.

Knowledge@Wharton: The hope is the doctors will be able to understand the effectiveness of the medication and whether some patients don’t require the medication as much as others, correct?

Oba: Yes. For the patients themselves, many have the question of, “OK, am I meeting tomorrow at 2 p.m. with the other board members of my company? Am I going to be showing signs of having Parkinson’s? How do I prevent that from happening? When do I need to take my medication to prevent that from happening?” You would think that it’s exactly two hours beforehand, for example. But that’s not the case for each and every person. Our company aims to have a personalized care for those with Parkinson’s disease.

Muniz: We’re currently in the manufacturing stage — not mass manufacturing, but just small prototypes. We made our first prototype over a year ago, and it was this really gigantic white box. Basically, a bunch of off-the-shelf components. Then we made it smaller with a batch of 15 of those. We discovered some problems with it. Now, we’re on a third version that we are calling “mark three” that we want to give to patients and have them try out.

Knowledge@Wharton: When people think about a wearable device, they think of a Fitbit or something along that line. Is the ultimate goal to pare the size down to something that is similar to that?

Oba: It actually is quite a few millimeters smaller than a Fitbit right now — that’s where our mark two is at. The one that we’re currently designing is going to be even thinner. We don’t have to worry about it being bulky. You’re not going to attract attention. Ultimately, what our patients want is to be able to track their disease without other people tracking them.

Knowledge@Wharton: Do either of you have a family member who was afflicted by Parkinson’s?

Oba: No, we don’t have a personal family member, but we did have a mentor through our years in college, who would like to remain anonymous, who does have Parkinson’s. It was after working with this individual for years that we realized that [sufferers of this disease could use] some extra assistance from a wearable device such as ours.

Muniz: Even though we have all this technology, there’s still a lot that we don’t know about Parkinson’s, and it’s because they don’t have the tools necessary to objectively quantify what’s going on.

Knowledge@Wharton: Sade, you mentioned a CEO who may be battling Parkinson’s and doesn’t want to show outwardly. We’re talking about a disease that has a stigma attached to it.

Oba:  Yes. One of the focus points of our company is, “How do we provide this service that gives our patients so much information, but doesn’t leak information to other people?” … We’re trying to find a way to give our patients a lot of information on how they can improve their everyday lives without necessarily broadcasting to the world that they have Parkinson’s disease. And that comes with a very small wearable and a phone application that they can use to track their information, and then they can choose who they want to share it with, whether it be their physical therapist or their physician or a family member or a caretaker.

“One of the interesting challenges is exactly how much information to share.”

Knowledge@Wharton: I guess the way to try and build this out is to have it connect to your smartphone or tablet or laptop so that you have that information available to pass onto a physical therapist, a doctor or a caretaker?

Oba: Correct. One of the interesting challenges is exactly how much information to share. Some people want every single data point. They want to know exactly how their arm was moving. Some people just want to know when they’re leaning on the table for too long, because that’s one of the symptoms. You don’t really realize it until you’re hunched over. Some people want simple information like that. “Oh, can you buzz me when I’m doing that? That’s all I really want to know.” How do we personalize the information on the app such as that? What other bits of information do patients want to know? How do we overlap that with what therapists want and what physicians want? That’s one of the things that we’re currently doing as far as our software development is concerned — how to have a unified, easy-to-use interface that caters to each and every person.

Knowledge@Wharton: How much of a learning experience has this been for you?

Muniz: Even though Sade’s a mechanical engineer and I’m an electrical engineer, during our time at Penn, we had so many resources that we just basically went crazy with learning a bunch of different things and taking advantage of the other students who can help us, and the professors. It’s all new things, but I think we’re kind of used to always learning new things and always pushing ourselves and just really discovering.

Oba: This is the most focused we’ve ever been. We have done a wide variety of projects together the past couple of years. We just never thought we’d come back to a medical device. We have known each other for about nine years now. We went to a high school for health professionals and vowed after spending four years shadowing doctors that we would never do anything in the medical field ever again. Lo and behold, we graduate college and the first thing we do is start a medical device company. It’s been interesting to come full circle and be this focused on one specific thing.

Knowledge@Wharton: Do you already have other areas that you would like to focus on in terms of the potential for this device?

Oba: Yes. At our prime, we hope to move forward and expand to other movement disorders –multiple sclerosis or even the rehabilitation of stroke patients — to really hit on all those people who need to track exactly how they’re moving on a daily basis, who may not actually have a cure in the moment and just need to know, “How can I be better at this exact time tomorrow?”

Knowledge@Wharton: What’s it been like having this company and seeing it develop in the short time that you’ve had it?

Muniz: It’s been really crazy. We have had to make tradeoffs. You can’t be a super human and do everything perfectly all the time. Obviously, our grades suffered a little bit, but we graduated and we got this prize. It was definitely worth it…. People have been contacting us left and right. Every time there’s a news article, there’s always a new partner that wants to try out our devices in their clinic. There are always new patients that just want to beta test. There are also people who are owners of manufacturing companies that [tell us], “I have Parkinson’s. Maybe I can help you.”

Oba: The network is expanding. We’ve been contacted by a lot of people. We’re trying to reel all that in and make sure that we are able to not necessarily cater to each person, but manage it in a way that fits within the timeline of growth within our company. That’s one of the fun things on the entrepreneurship side: How can we make sure all these people fit into our timeline? Is it possible?

Knowledge@Wharton: Is the third version that you’re working on now going to be the one that has the opportunity to be in the market? Or are there still pieces that you’re tinkering with and trying to make better?

“Ultimately, what our patients want is to be able to track their disease without other people tracking them.”

Muniz: It’s not in the market for sale yet because of government regulations — the Federal Communications Commission and also, potentially, the FDA. Those are certifications that we must have before we’re able to sell the physical device. However, the service can be sold. But at this point, we’re not interested in making money yet; we’re just interested in refining the device. There are still one or two more iterations before we can actually go into mass manufacturing and legally sell the device.

Knowledge@Wharton: Why do you need FCC approval?

Oba: Because of our wireless communication. If you wirelessly communicate in a device that you’re making, then you need to have this certification. It’s kind of a gray area when you’re buying someone else’s chip off the market or if you’re designing your own. But currently at our stage, we would need FCC approval to be able to do that.

Knowledge@Wharton: How far away do you think you are from going to the FDA?

Oba: By the end of 2017. We’re not that far away. What helps is to have a physician on hand who has a set of patients that they’re doing studies on, so you’re able to do a trial beta test. Now that we have those individuals and our new devices are being made and the only thing that’s really being tweaked is the software, we’re almost at that point after a few months of testing with these individuals … to be able to approach the FDA and get the process started.

Knowledge@Wharton: Is tackling something like Parkinson’s easier to do these days because of the technology?

Muniz: This technology is not new. There are companies that have these sorts of devices, but the problem is that they’re really expensive. A hospital will only have one or two of these because they can’t afford to give one to each patient, let alone have them take it home. What we’re doing here is creating a new price point, bringing that sort of technology to the consumer, to the patients, to everyone that needs it.

Knowledge@Wharton: When you started at Penn a few years ago, this was not the path that you originally thought you were going to go down, correct?

Oba: We both thought that we would end up in product design firms in California with all of our other peers.

Muniz: When you enter engineering, the dream is California. You’re working for Apple or Google. But once you intern there, it’s kind of like, “Oh, that’s it?”

Knowledge@Wharton: It has to feel very good that you have gone down this path and that there is a light at the end of the tunnel.

Oba: This has been the most rewarding thing. I think the light isn’t as bright as we would want because once you start working in the Parkinson’s space, the biggest light, the brightest light, the actual end of the tunnel is a cure. Our company does not provide a cure. We don’t advertise that because it’s not possible on our end. But what we do strive for is to make all the other moments of your life easier for you, more bearable for you, more manageable. So you feel as if you have some of the control back that the disease has taken from you. That’s the best thing that we can provide and what we get the greatest feedback on…. That we’re in this space and that we’re making active change and that we’re moving as quickly as we can — people really, really appreciate that and are getting really excited about it.

Knowledge@Wharton: What is your hope for the company in the next 10 to 15 years?

Oba: In the next 10 to 15 years, I think we definitely want to get acquired because we’d want to be able to expand our outreach to the point where a smaller startup wouldn’t be able to do that. But in the next five years, it’s the whole expanding to other movement disorders, tackling Parkinson’s, having a good network of therapists and physicians in this area to help continue improving therapy regimens or knowing which medications are best for each patient and when they need to be taken. Then, it’s moving onto other conditions that also need the same treatment that the Parkinson’s community is now getting from Xeed.

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"A New Approach to Parkinson’s Disease: How Robotics Can Help." Knowledge@Wharton. The Wharton School, University of Pennsylvania, 05 August, 2016. Web. 23 November, 2017 <http://knowledge.wharton.upenn.edu/article/a-new-approach-to-parkinsons-disease-how-robotics-can-help/>

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A New Approach to Parkinson’s Disease: How Robotics Can Help. Knowledge@Wharton (2016, August 05). Retrieved from http://knowledge.wharton.upenn.edu/article/a-new-approach-to-parkinsons-disease-how-robotics-can-help/

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accessed November 23, 2017. http://knowledge.wharton.upenn.edu/article/a-new-approach-to-parkinsons-disease-how-robotics-can-help/


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