Jeremiah Robison, Founder, and CEO of Cionic Shares Insights on the Collaboration with Yves Behar’s fuseproject for the Cionic Neural Sleeve

Shots:

Jeremiah spoke about Cionic’s recent collaboration with designer Yves Behar and his design firm, fuseproject to deliver its bionic leg wearable to determine human mobility in real-time
He talked about the results from the CIONIC trial and also discussed home usability trials to understand the impact of the Neural Sleeve on mobility over time
The interview provides a profound understanding of Cionic’s advancement to develop AI wearable devices to help people with mobility differences

Smriti: Give us a brief detail about your collaboration with fuseproject. How has this collaboration synergistically affected the ability of the Cionic Neural Sleeve to aid in mobility differences?

Jeremiah: Building bionic clothing that can augment human movement takes a thoughtful and holistic approach. The collaboration between fuseproject and CIONIC marries thoughtfully inclusive design with revolutionary mobility technology. It starts with advanced technology capable of adapting to each user's mobility needs to deliver meaningful outcomes. It is then designed to be comfortable to wear and effortless to use. From software to soft goods, the team of experts at CIONIC and fuseproject have pushed the boundaries of the human-machine interface to deliver the future of assistive technology.

It was also imperative that the product not only has a significant improvement for users physically but also removes some of the emotional burdens that come with having a mobility difference. This meant building a product in tandem with potential users to understand their needs and create the best possible solution.

Smriti: Why choose a fuseproject for the designing of the Cionic Neural sleeve? What helped make this decision?

Jeremiah: As fuseproject’s Yves Behar has stated, “Good design serves to humanize technology and provide life-changing solutions.” The ability to expertly integrate advanced technology and human-centric design takes experience and trust, and the world-class design team at fuseproject has an exceptional record of success ranging from startups to Fortune 100 companies. Yves and I have worked together for over a decade across multiple projects in wearables and medical technology. When it came time to select a partner to collaborate on a design that complemented our breakthrough technology, I knew that partner had to be a fuseproject.

Smriti: Explain the details of the CIONIC trial along with the key findings obtained through the study.

Jeremiah: CIONIC recently completed a multi-site study investigating the improvement in dorsiflexion and inversion during gait in people with foot drops due to a variety of neurological conditions. Foot drop is a common symptom of multiple sclerosis (MS) and other conditions that limit an individual’s mobility. When subjects walked with stimulation provided by the Neural Sleeve compared to walking without stimulation, ankle dorsiflexion at heel strike improved by an average of 5.2 degrees while ankle inversion during the swing phase of gait was reduced by an average of 3.6 degrees, bringing the ankle to a more neutral position for stabilization. During this study, 94% of users experienced improvements in foot clearance during walking. A preprint of that study is available at https://www.medrxiv.org/content/10.1101/2022.04.27.22273623v2.full

A more recent survey was conducted over a period of eight weeks and collected user reported outcomes. In addition to a reported improvement in mobility during the study, the number of users experiencing moderate to severe pain was reduced by 60%, and the number of users experiencing moderate to severe anxiety or depression was reduced by 75%.

Smriti: Please highlight the key features of the Cionic Neural Sleeve.

Jeremiah: The Cionic Neural Sleeve is the first product to combine the diagnostic power of a multi-million-dollar gait lab with the therapeutic power of Functional Electrical Stimulation (FES), all delivered in a comfortable, attractive legging that can be worn anywhere and operated by a smartphone.

Packed inside the Cionic Neural Sleeve is the breakthrough, proprietary Read+Write Neural Interface that can not only read the signals sent from the brain to the muscles but also activate the muscles directly using FES. The interface starts by measuring the neuromuscular system from the electrical signals being transmitted by the brain to the resulting kinematics of the body to predict movement in real-time. Advanced algorithms then precisely steer electrical current to activate individual muscles in perfect sequence.

The Neural Sleeve is also the first comprehensive system that addresses all four major muscle groups of the leg, and the software-steered current and sensor array means that a user will get a consistent experience with every use.

Finally, the Neural Sleeve is context-aware, meaning it knows whether a user is walking, sitting, standing, etc.; adjusting stimulation automatically so it is only delivered when needed.

Smriti: Would you please provide some details about the CIONIC App? How does this app help users control their own mobility?

Jeremiah: The CIONIC application for iOS and Android puts mobility into the hands of the user. The app enables a user to easily customize settings for each muscle group; controlling the intensity of the electrical signal, as well as the frequency and pulse width. The intuitive interface allows the user to optimize the system for their individual needs, and contains a library of content and exercises to further personalize the experience

Smriti: What are some of the advancements that fuseproject has provided to the Cionic Neural Sleeve?

Jeremiah: The fuseproject team developed over fifty different form factor prototypes during the design process, working closely with potential users to ensure that the final design delivered against a few critical factors. First, it had to look like a regular garment, not an assistive device, with a design that people were proud to wear. It also had to be lightweight and optimized for all-day wearability so our users derive a continuous benefit as they live their lives. Finally, accessibility was key. Many individuals with mobility differences have difficulty using their arms, so it was essential that the Neural Sleeve could be put on or removed with the use of only one hand if necessary.

Smriti: You have mentioned that this work pushes the boundaries of human-machine interface “from software to soft goods.” Would you please mention some of the obstacles faced during the process?

Jeremiah: The Cionic Neural Sleeve is the world’s first true bionic clothing, so there was no playbook for us to follow. Instead, the team had to conduct extensive research on the different technological aspects of the product in order to make it a reality. For example, integrating electronics inside of a garment is extremely difficult to achieve, so hasn’t really been done before in a material way. We researched everything from e-ink to conductive thread before we landed on a solution that had high signal quality and robust wearability. We also integrated electromyography (EMG) and FES into a single electrode array, which is an incredibly challenging technical feat. We also needed to collect data for algorithm development and validation on a large number of patients. This was especially challenging during the pandemic when many of the large academic centers were closed to research studies.

Smriti: CIONIC has taken a tremendous step at providing independence for people with mobility differences! Are there any other products in CIONIC’s pipeline?

Jeremiah: We announced FDA clearance in March and the CIONIC team is now laser-focused on bringing the Neural Sleeve to market in late 2022 for our first group of users (individuals with diagnoses of multiple sclerosis, cerebral palsy, stroke, spinal cord injury, and other upper motor neuron conditions). Next, we’ll extend our gait assistance protocol to new populations with updated algorithms and clinical validation.

By 2050, 20% of the world’s population is projected to have a mobility difference, so we know that the challenge is bigger than just our team. We built the CIONIC open augmentation platform from the ground up, creating an ecosystem that enables third parties to build new mobility solutions at software speeds and software costs.

Our vision is to create a world beyond disability, where all humans have the opportunity to move without limits. Bionic clothing capable of sensing, analysis and augmentation will make that vision a reality for millions of people.

Source: Cionic

About the Author:

Jeremiah Robison is the Founder and CEO of CIONIC. Robison developed the lower leg Neural Sleeve, via software development, product design, and individual trials. He is a proponent and an advocate for creating better solutions for people with mobility issues caused by neurological conditions and illnesses such as cerebral palsy, multiple sclerosis, stroke, and more. Jeremiah has a BS and MS in Computer Science from Stanford University.