Device helps stroke patients recover at home



Highlights from Interview Conducted with SynPhNe Founders Dr. Subhasis Banerji and Dr. John Heng

Patients who have suffered a stroke or serious injury often go through months of hospital therapy in the hope of regaining muscular functions. Dr. Subhasis Banerji and Dr. John Heng have developed a wearable device called SynPhNe (pronounced like “symphony”), which allows these patients to undergo rehabilitation at home. The SynPhNe system consists of a specially designed headgear with neural sensors and an arm gear with muscle activity sensors. Patients then do guided exercises by following onscreen videos. In the second of a four-part series about innovative healthcare companies, Chia Yan Min speaks to Dr. Banerji and Dr. Heng about revolutionizing the way therapy is delivered.

Q How was SynPhNe born?

Dr. Banerji: It started with me experimenting with rehab on myself after I underwent a brain-muscle injury in 1998 in India. I was involved in a serious car accident and smashed my hip and was left with cognitive disabilities. Doctors said I would never walk without an aid again. I was about 34 years old then, and I didn’t have anything to lose from trying something new. I was already practicing yoga and some forms of martial arts then. So, I experimented with some of those techniques and achieved remarkable results after a few months.

My health was such that I could not continue my previous work – an engineering business in India – so I became a therapist for five years because I saw that I could help people.

I met John in 2007, when I went to the Nanyang Technological University (NTU) in Singapore for my Master’s in Biomedical Engineering. He was faculty there and already working in the field of robotics.

We started doing research to develop the system around 2008. We did some initial studies at Tan Tock Seng Hospital (TTSH) with nine patients, and a follow-up trial, after that, in which we got very good results. We received an innovation grant from National Research Foundation (NRF) and Singapore-MIT Alliance for Research and Technology and later another grant from SPRING Singapore.

We decided to form the company in 2013 – before that, we had been working out of the robotics lab at NTU. We coined the name SynPhNe, which stands for “synergy between physio and neuro”.

In October 2016, we did a demo with Harvard Medical School and we were selected for a pilot study. We have collaborated with them since then to make our technology USA ready.

Q How will SynPhNe help patients, therapists and hospitals?

Dr. Heng: When we were working with TTSH we could see there was a real resource and capacity crunch among the therapists. Each patient needed many hours of therapy a week and there were only so many therapists available.

We realized SynPhNe can help solve the therapist capacity crunch by supplementing a patient’s time with therapists with home-based rehabilitation.

However, because this is such a paradigm shift from the way traditional therapy is done, it took an enormous amount of effort to convince the establishment of this.

Our technology combined the principles of neuroscience, developmental biology and physical therapy with the movement and mental focus techniques in yoga and martial arts.

We asked therapists to give us patients they thought had gone as far as they could with hospital treatment. Patient after patient after patient improved after just a few weeks. These were patients who had come out of three or four years of traditional therapy. We had them opening bottles, writing, even playing the guitar in some cases.

Dr. Banerji: Another traditional concept is associating treatment with a hospital or clinic. In 2013, the number of people with a permanent disability crossed one billion. In Singapore, we have more than 200,000 people who require daily therapy, but we barely have 400 therapists.

TTSH sees between 40 and 50 patients a day with a 30-member team. A similar team in India, where we did a trial in 2015, looks after 300 a day. In the United States, because the cost of one session is so high, dropout rates are also high once insurance support stops.

This problem exists everywhere.

This just seems to be a market going out of control and 60 percent of the market is invisible because the patients have dropped out of healthcare entirely. They have accepted their condition, that it’s the best that medical science and therapy can do for them.

Dr. Heng: With the aging population in Singapore, the Government wants more independent living. The family nucleus is already so small, with very little resources to devote to caregiving. The more we can get people back into the workforce, or even living independently, the quality of living will go up and we can free up resources.

Q How do you plan to make the device more widely available and which markets are you targeting?

Dr. Banerji: We’re operating in three markets to start – India, US, and Singapore.We’re going to the US early because it still leads the thought leadership. Once we get confirmation and sponsorship from a large institute there, the acceptance in Asia will be faster and we can scale up more quickly.

But there’s also the question of cost. People spend a lot now to support a stroke patient at home, for instance, buying hospital beds. We want to financially model our business such that we’re not subsidizing anyone, because that would not be sustainable.

We’re looking at providing the customer options, depending on the type of market in each country – such as outright purchase, a rental model, monthly installments or a microfinance model, to name a few.

In Asia, we are also looking at delivering rehabilitation therapy and expertise via a franchise of training centers – the centers will be located close to patients and they can go there to learn how to use the device at home.

Q Does the platform have other applications beyond treatment of stroke patients?

Dr. Banerji: What is available today is the arm and head gear, to recover movement in arms. Development is under way for the lower limbs and eventually, we plan to look at the whole body. The present system can train trunk control and balance as well. We’ve achieved early success in treating patients with traumatic brain injury, learning disabilities and aging related effects.

If we have many units distributed across different geographies, we can easily distribute new software by asking people to subscribe.

Also, what’s great about this is everything is being monitored – the device collects data on the patient’s progress, which therapists did not previously have access to.

In the past, patients had to go back to the therapist and it’s all guesswork as to how they did at home, but here, it’s all measured.

Dr. Heng: There are many applications, not just in physiotherapy. The system can address ageing, stress-related disorders, attention deficit hyperactivity disorder, other challenges of modern-day living.

We’ve developed a platform and we can do multiple things with it. We have started off with rehabilitating stroke patients, and recently expanded into additional conditions, and are very excited about the platform’s potential in in a whole range of possibilities.