Rockin' Recovery

By Anna Lynn Spitzer

Irvine, Ca, May 15th, 2014 -- One wouldn't expect the leaders of a company specializing in products for stroke patients to be in their mid-20s. But youth is clearly the genius behind Flint Rehabilitation Devices, a startup company headquartered in TechPortal, the Calit2 technology business incubator.

Zondervan (left) and Friedman are rethinking traditional
approaches to stroke therapy. (Photos: Steve Zylius)

Nizan Friedman and Danny Zondervan, both recent doctoral graduates of UC Irvine's Samueli School of Engineering, admit that a few years ago, they didn't think a whole lot about the 795,000 Americans, mostly older adults, who suffer a stroke each year. But their engineering skills  — Friedman in biomedical and Zondervan in mechanical  —  and their Millennial-generation love of the video games Guitar Hero and Rock Band have placed the duo in the unlikely position of rethinking the traditional approach to stroke rehabilitation.

By summer of this year, their company will launch its first product, the Music Glove, a device designed to help stroke patients with hand paralysis regain function. The device can be used at home or in a clinic to augment traditional physical therapy.

Friedman hit upon the idea while working on a hand robot under the auspices of engineering professors Mark Bachman, director of the eHealth Collaboratory, and David Reinkensmeyer. Bachman urged Friedman to design something simpler than the highly complex robots many researchers were working on. A later discussion between Friedman and Bachman – both musicians, as is Zondervan – sparked the idea of adding music to the device.
"We tried it out and it worked really well to help people recover hand function after a stroke," recalls Friedman, the company's president. "It just seemed to click."

The device is a glove with sensors on the fingertips that works with a dedicated game console or a touch-screen tablet device. Much in the same way that someone playing Guitar Hero hits buttons on a guitar to sync with notes on the screen, the Music Glove wearer taps notes with his fingertips and thumb to the beat of a song. Playing the game prompts the neural connections between the hand and brain to recover.

"The reason our software is inspired by Guitar Hero is because people get addicted to the game," Friedman says. "We want people to get addicted to therapy. Anything that can motivate people to do therapy for a long time is the right way to go."

The Music Glove went through many iterations, however. Reinkensmeyer provided valuable insights into the field of rehabilitation and the pitfalls of trying to build highly complex, expensive robots.

"Simple devices have a better chance of actually being used by people, especially in the home environment," Reinkensmeyer says.

MusicGlove is inspired by "Guitar Hero."

Eventually, Friedman and Zondervan launched clinical trials of the product in the eHealth Collaboratory. The study participants, who were more than six months out from having a stroke resulting in disability, used the device for two weeks. Their progress on timed tests – such as moving a pile of blocks in 60 seconds – was compared to a two-week period in which they performed standard physical therapy.

The study demonstrated that the Music Glove produced a threefold improvement in function compared to traditional therapy. Better yet, says Zondervan: "People just seemed to love it."

Janet Johnson, 59, entered the clinical trial after suffering a severe stroke that caused right-side paralysis. Physical therapy helped her learn to walk again, but her right hand remained stubbornly and severely affected until she began using the glove.

"I really fell in love with it," says the Los Angeles woman. "You hit the key you want to hit without thinking about it. You get in the flow. You just groove along to the song, and the next thing you know, you've hit every note."

After using the device for three months, Johnson found she could once again type efficiently and use the television remote with her right hand.

The key to a successful rehabilitation product is to integrate the human experience with technology, Bachman says. "Innovation is about designing something human beings will use that makes them feel good and is helpful."
Friedman and Zondervan learned some of their early prototypes were too complicated for some stroke patients. After all, most stroke patients are not of the Guitar Hero generation.

"Cancer in a sense is a breakdown of DNA repair, and the rearrangements that we see are unrepaired mistakes in the process of DNA replication," adds Raphael. "There are whole classes of genetic diseases that are inherited and passed down from a parent. Mutations in our DNA can be single-letter changes like those that occur in cystic fibrosis, or they can involve multiple chromosomal rearrangements such as those associated with solid tumors."

Raphael was planning to apply for a faculty position this year, but says the BWF award will afford him an easier transition. "I now have a little more freedom to do research and stay here at least one more year," he explains. "I plan to apply for a faculty appointment in 2006." His future destination is unclear: "Depending on the university, bioinformatics work is happening in the computer science department, math department, biology department, or in an interdisciplinary center." Raphael says that he favors teaching in a quantitative department but wants to maintain close ties with biological researchers.

"I think this award shows UCSD is a great environment for doing work at the intersection of biological sciences, quantitative mathematics and computer science," says Raphael. "It is an award for UCSD, not just for me.