This robot helps in the therapy of hand injuries

Slipped with the knife while cutting vegetables - that's how quickly a tendon can be severed and an operation may be necessary. However, the operation is only the first step on the road to recovery, because afterwards it is important to ensure that the hand retains its mobility and slowly regains its strength. The Mainz-based startup LIME medical has developed a therapy robot for this purpose. In an interview with 5-HT, Désirée Leppla, responsible for content marketing at LIME, presents the "AnyHand", which should make it possible for patients with hand injuries to carry out individualized therapies from home in the future.

What problem does LIME address?

Every year in Germany there are up to 400,000 hand injuries. These are mainly accidents at work or accidents at home, for example when someone has cut a tendon and needs surgery. Especially after hand operations, continuous movement therapy, accompanied by an occupational therapist or physiotherapist, is necessary so that the structures do not stiffen and the ability to move is slowly regained. If a patient suffers a hand paresis after a stroke, it is also important to keep the joints and tissues of the hand flexible so that they remain functional when the paralysis subsides. However, there are not enough hand therapists in Germany, so that patients often have to wait a long time for a therapy place. Even when they are finally in therapy, they do not get as much therapy time as would actually be necessary. This is where our AnyHand comes in: a therapy robot into which the hand can be placed and which then carries out individualised therapy programmes.

What does the AnyHand look like - and how can therapy with a robot be imagined?

The AnyHand has five silicone loops in which the patient can place his fingers. In passive movement therapy, the patient lets the hand go and the AnyHand performs the movements. This serves to prevent stiffening, for example in the initial period after an operation. In assistive therapy, the patient helps himself and the AnyHand supports him where his strength is not yet sufficient for certain movements.

To what extent can the therapy be personalized to the individual condition of the patient?

Before the first therapy, the occupational therapist or physiotherapist measures the size of the hand using a template and enters the data into the device. A patient file is then created and the AnyHand moves into the correct position at the push of a button each time it is used. This automatic size adjustment, for which we also have a patent, ensures that the AnyHand is adapted to the patient's hand. As far as the therapy itself is concerned, the therapist specifies the basic conditions via an app on the tablet: Which finger should be moved how far? During the application, data is collected that can be used to observe the history. Although the AnyHand is a device for a broad range of patients and a large spectrum of hand problems, these technical possibilities still allow us to carry out highly individualized therapies.

What data does AnyHand collect - and what conclusions can be drawn from it?

The sensors record how often, how long and in which programs the patient has trained and also to what extent he has exhausted his range of motion. In addition, the patient himself can give feedback on how he felt about the training. We are currently expanding AnyNet, a cloud in which this data is collected so that doctors, therapists and patients can access it. We want to use it to network all the players involved online, so that in future patients can train from home and still be monitored by therapists and doctors. This will also enable precise appointments: The patient does not automatically have to come for a follow-up every four weeks, but makes an appointment exactly when it makes sense.

What are the advantages of using AnyHand for the parties involved - whether patients, therapists, doctors or health insurance companies?

Patients naturally benefit from the increased therapy time, because the motto is: A lot helps a lot. Therapy with the AnyHand prevents stiffening, which sometimes leads to follow-up operations - which is also a problem for health insurance companies, because operations are expensive and extend the rehabilitation period. With the AnyHand we do not want to replace the work of occupational and physiotherapists, but rather to complement it. By using robots, the therapists are freed up for more complex tasks. With the same personnel, clinics and practices can thus create more therapy time. For the entire team, including the doctors involved, it also makes for more satisfying work if you know that follow-up care is assured. Thus, all involved parties benefit from the AnyHand.

How did the foundation of LIME Medical come about?

The two founders, Pascal Lindemann and Dominic Libanio, got to know each other during their schooldays. Everything started with a project at "Jugend forscht": Pascal had the idea of developing a robot hand that could be used in space and controlled from Earth, for example. This led to the idea of building a hand prosthesis. Pascal presented the project to a hand surgeon from the University of Mainz, Dr. Eric Hanke, who said that there were not many hand amputations in Germany. What was really needed, however, was a device to help with hand injuries. That is the gap we want to close.

What is the current status of developments?

LIME was founded in October 2016. Since then we have been involved in development for three years. Because the human hand consists of many joints, muscles and tendons in a small space, it was a complex challenge to map this on a device suitable for everyday use. We are therefore glad that we have now reached this milestone. Certification as a medical device was also very time-consuming, and we are currently still waiting for the final steps of approval. The market launch is to take place this year. We are already in contact with various clinics and therapeutic practices for this purpose. The response has been very positive - we are noticing that we are meeting a great demand with our product.

How will the AnyHand be financed?

We want our product not to be a private service, but to be used by the broad masses. Therefore it is very important for us to convince doctors, therapists and health insurance companies of the advantages of AnyHand. In the first phase after market entry, rehabilitation clinics and therapy practices should initially purchase the device and bill the therapy time via health insurance companies. The patients can then use the AnyHand on site in the clinic or practice. In the second phase, our goal is for medical supply stores to purchase the AnyHand and lend it to patients via health insurance companies so that they can carry out the therapy independently from home.

What is your vision for the future?

Our vision is to redefine the status quo of hand therapy by providing additional therapy time. At the same time, we will create a digital ecosystem of doctors, therapists and patients to ensure the best results for all.

How was the cooperation with the 5-HT Digital Hub so far?

The cooperation so far has been trusting and constructive. We have already been able to present our company and our services to an international delegation from South America and Eastern Europe at the 5-HT event "Health Fair for HealthCare" and establish valuable contacts.

Where can 5-HT help you in the future?

We hope that the 5-HT Digital Hub network will enable us to further expand our network and gain access to relevant companies and investors in the healthcare sector. A further opportunity for us is the next 5-HT event „Insuring Digital Health“, where we can explore cooperation possibilities with health insurance companies in an individual speed dating session. We are looking forward to working with the team of the 5-HT Digital Hub.