More than four million Canadians and Americans use walkers to improve their mobility – but falls while using one cost untold suffering, and more than $330M in healthcare costs per year.
That’s why, when Wagner Souza, a recent Medical Innovation Fellow, was asked, ‘why are you developing a walker when there’s already a well-established industry?’ he responded with a question of his own: ‘Then why do so many people still fall?’.
Souza’s experience as a person with limited mobility, combined with his expertise as a physiotherapist and a neuroscience PhD, fueled his desire to fill the gaps he sees in medical devices.
It has led to developing a ‘smart’ walker, shoe insole and wheelchair mould – all of them equipped with tools based in neuroscience.
“In a clinical setting, you have a lot of ideas to solve problems, but you don’t have the tools and knowledge to translate the solution into reality,” Souza said. “I wanted to learn how to bridge clinical setting to medical device industry.”
That’s when he discovered Western’s Medical Innovation Fellowship Program operated by WORLDiscoveries in partnership with BrainsCAN.
From July 2019 to May 2020, he and his Medical Innovation Fellowship team researched, observed and innovated. They spent months at Parkwood Institute, emergency rooms and operating rooms to determine patient and clinician needs.
What makes these products different from what’s already available is that they were all carefully designed with the same goal – applying neuroscience to smart assistive devices and improving lives.
“Giving people with limitations a better quality of life. That’s the point. That is my ultimate goal.” Wagner Souza, 2019-2020 Medical Innovation Fellow
Next, Souza is going to bring these devices to market. His soon-to-launch company, Thalamus, is named after the region of the brain responsible for relaying information from a person’s surrounding environment to other areas of the brain that are responsible for processing effective responses.
The company’s primary product will be Souza’s innovative walker.
One version will feature an elliptic structure and automatic braking. “Most people who have walkers have a delayed reaction time. It’s neuroscience,” Souza said of the importance of automatic braking. “Reactions can be delayed up to 1.5 seconds, which is enough time for a fall to easily happen if your walker has manual brakes.”
The elliptic structure means users can have varying body weight support, which currently is possible only while in a clinic. “The back-rest doubles as a saddle-like harness so you can walk with different levels of weight supported. You can have a lot of support, some support or none. It’s very versatile. I’ve worked on gait for the past 10 years and I’ve seen that partial body-weight support benefits a lot of people going through rehabilitation.”
A more advanced version of the walker will include haptic and pressure sensors in the handles that will vibrate if they detect the body centre of mass is shifting too much. A sound alarm will alert the user if their imbalance is about to result in a fall. All of this information, plus steps, will be tracked on a phone app, which will also help clinicians.
“Everything about this walker was conceived with neuroscience concepts in mind. Reaction time, stages of gait, balance distribution, how the wheels are positioned, concept of personal space, and more,” said Souza. “It will pose a significantly smaller risk for falls.”
The second medical device, the custom-fit wheelchair mould, will help children with disorders that affect biomechanical adaptations, mainly patients with cerebral palsy (CP). These children need a special seat, harness and structure around them for their safety.
Currently, it takes up to nine months from the time the child is precisely fitted to the time their customized wheelchair mould arrives – by which time the child has often grown out of the new mould.
Souza’s wheelchair mould will be adaptable so that it can be reshaped to fit the child and be taken home the same day or a day later.
This less expensive and more effective option will also communicate with a phone app. “It will tell parents where the peak pressure points are on the seat to avoid pressure ulcers, which are very common in children with CP,” said Souza. “These children have a difficult time verbalizing, so they can’t tell their parents or caregiver where they’re hurting. This is an awful reality for many families. The phone app will alleviate that problem.”
The third medical device is a smart insole. Like the walker and wheelchair mould, it will connect with an app and show gait speed, pronation, supination and how pressure is being distributed. It will also send an alarm if something is in the user’s shoe and harming their foot. Although most people can feel a pebble in their shoe, some diabetics and others experience peripheral neuropathy and lose sensation in their feet.
“I had a diabetic patient whose grandson’s Lego piece was in his shoe. Since he had neuropathy and couldn’t feel it, it created an ulcer. Diabetics also have a much more difficult time healing, so his foot was eventually amputated because of a Lego piece in his shoe.”
The insole, technology adapted from the University of Windsor’s flexible pressure sensor, earned Souza and his team the top prize at Western’s Proteus competition.
Once Souza has the funding to build a walker prototype, and pending the resolution of COVID-19-related delays, he can begin to test the devices with patients at Parkwood Institute. He hopes to bring these life-enhancing devices to market in mid-2021.
Grants back medical innovation efforts, June 2018
Fellowship pushes boundaries of medical technologies, November 2016
New fellowship puts innovation at forefront, November 2015