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Innovative Reflex-based Gait Rehabilitation

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An electric zap to get stroke patients back on their feet

An innovative technology uses small jolts of electricity to trigger leg movement, providing faster rehabilitation than physical training alone.

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Stroke is the third leading cause of disability, and across the EU, almost 5 million people are expected to be living with stroke as a chronic condition by 2035. The socio-economic burden of stroke is estimated to be EUR 45 billion annually in the EU alone. Among the lasting effects of stroke is difficulty walking, which can have a severe impact on the patient’s health, reflecting a loss of income, self-reliance and dignity. To tackle this, the EU-funded project INNOGAIT investigated the market potential for an innovative rehabilitation toolkit that uses small jolts of electricity to trigger leg movement. “Gait problems are one of the most common issues after a stroke,” says project coordinator Christian Christiansen. “More than a million people have a stroke every year in the EU, and 60 to 70 % have this problem.” If this hemiplegia is not treated promptly and effectively, it can lead to lifelong disability.

A painless prickle

INNOGAIT’s solution is Incedo, a device produced by project host Nordic-NeuroSTIM. The small device is worn against the foot, where sensors can track the patient’s pattern of walking. Once the stimulus level has been adjusted, the device delivers an electrical stimulation at the appropriate moment to trigger an upward pull of the leg, including a strong hip flexion. “Our solution uses the withdrawal reflex, which activates if you step on a nail or stone,” notes Christiansen. Because this reflex occurs in the lower spine, it remains intact even in cases where lower limbs cannot be moved due to brain injury. “It’s not a painful feeling,” he adds. “It’s a little strange but it has a lot of benefit for the patient.” Daily, half-hour sessions over 15 days are enough to make lasting changes to the brain resulting in improved mobility, compared to physical therapy alone, says Christiansen. The Danish firm has already released Incedo in Denmark and has a small number of devices in use in Austria, Germany and Switzerland.

Personal mission

If patients’ mobility can be saved, the cost savings to healthcare authorities are huge, explains Christiansen. A live-in nurse can cost more than EUR 100 000 per year, whereas a timely course of physical rehabilitation with a trained therapist only costs in the region of EUR 2 000. The project was supported by the EU’s Horizon 2020 programme. “This helped us get more clinical data, to expand the indications of the device, and have patients trained at home,” notes Christiansen. He adds that the company’s business plan and marketing strategy were also strengthened during this time, allowing the company to better understand how to position Incedo on the market. Christiansen says the company now plans to expand into other countries, including the Netherlands, Norway and Sweden. For Christiansen, it’s a personal mission: “My father had a stroke that affected his walking and speech,” he explains. “It is an important area that is not getting enough focus. If high-intensity training is provided early on, so much can be gained later.”

Keywords

INNOGAIT, gait, stroke, walking, mobility, hemiplegia, electrical, stimulation, sensor, foot, jolt

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