Deadly earthquake inspires idea of robots as physical therapists

MANY boys grow up dreaming about building robots one day, but Alex Gu is among the few who has turned the dream into a career.

Now chief executive officer and partner of Shanghai Fourier Intelligence Co, Gu isn’t focused so much on industrial robots, one of the most popular applications. Rather, he is developing robots that assist patient rehabilitation in the healthcare system.

Gu, 37, was working for a US-based multinational corporation in 2008 when he decided to quit and start his own company manufacturing automated equipment for factories.

He proved to be a successful entrepreneur, making a small fortune when he sold the company. With the proceeds, he founded Fourier Intelligence in 2013.

He named the company in tribute to French mathematician Joseph Fourier (1768-1830), whose Fourier series led to applications addressing problems of heat transfer and vibrations. He is also generally credited with the discovery of the “greenhouse effect.”

What is known today as the Fourier transform is used in a wide range of applications, such as image analysis and filtering.

Sitting in his brightly lit office in the Zhangjiang High-Tech Park in Pudong, the bespectacled Gu, a Shanghai native, told Shanghai Daily that this second start-up was inspired by after-effects of the devastating Sichuan earthquake in 2008.

The quake left 70,000 dead and countless others maimed or paralyzed. Those with permanent spinal injuries were relegated to lives in wheelchairs. This deeply saddened Gu.

Only after the deadly quake did Chinese medical schools seriously start training therapists specializing in rehabilitation.

“These quake victims deserve a better quality of life, and rehab is the key to that,” Gu said.

Discussions with medical experts revealed that the number of qualified therapists fell woefully short of demand. Currently, an average rehab therapist tends to to 10 patients. The surging incidence of strokes and other neurological diseases in China is fanning demand for their services.

Most of rehab therapy is person-to-person. That means, for example, that therapists have to be with patients as they are led through series of highly repetitive movements.

“This is woefully inefficient,” said Gu.

The advent of artificial intelligent (AI), among other vanguard technologies, may be at least a partial solution. In most cases, robots can help patients perform repetitive tasks as well as a human therapist.

A rehab robot manufactured overseas normally costs between 3 million yuan (US$448,000) and 5 million yuan. Development of domestic capability reduces costs.

More importantly, human therapists can be freed from what is dull, monotonous work to tend to other work, such as analyzing rehab progress and developing rehab plans.

“AI will not replace humans altogether because robots, unlike humans, have only intelligence, not wisdom,” Gu said in a message likely to resonate with professionals.

His company now mainly makes two models of rehab robots. The Fourier M2 is designed to aid upper limb rehab; the Fourier X1 aims at lower limbs and is designed to help a patient walk again.

Fourier M2 uses reward-based therapeutic games to motivate patients to complete a series of movements. On instructions from the computer, the patient grabs a handle and pushes and pulls it to guide a virtual “hand” that harvests fruit and vegetables displayed on the screen.

The working mechanism is basically like this: the clutch power from the user’s hand sends a signal to built-in sensors that decide whether the user’s muscle strength is enough to push or pull the handle. If not, an “assistive force” can be provided to help complete the designated tasks.

Rewarding progress

Each treatment session, which lasts 30 minutes, is followed by an assessment of the patient’s condition and a few words of praise or encouragement.

This reward-based, immersive game experience is apparently something new for many patients. The initial feedback has been fairly positive.

Gu recalled the case of a retiree living in a local nursing home. The man was a badminton buff but didn’t have the strength to hold a racket. Assisted by Gu’s robot, he now “plays” again using a virtual racket on the screen.

Gu said it warmed his heart to see the happy smile on the old man’s face.

In China, many patients want to be treated primarily in Class-A hospitals – the top of the three-level public hospital system. They are convinced that lower levels are inferior. This has contributed to the overcrowding in top hospitals and an over-concentration of medical resources.

As Gu sees it, this, too, is deeply inefficient, and he thinks the growing popularity of rehab robots could change the face of the industry.

“You don’t need to go to a hospital to be treated,” he explained. “Patients can receive quality, consistent treatment in the comfort of their own homes.”

With social value inevitably comes commercial value. His company, which has just completed a round of funding, is working to tap that value as the leading rehab robot manufacturer in China.

His products have been purchased by top local hospitals like Ruijin and Huashan, and are also deployed to secondary hospitals, community health centers and private rehab clinics.

At Ruijin and Huashan hospitals, each robot treats a maximum 20 patients a day for a fee of dozens of yuan per session, said Gu. There are long queues of patients still waiting for rehab.

While most rehab patients are in hospitals, he said he sees a much bigger market in communities and private homes.

“Since there are 30,000-plus rehab facilities in the US, over 15,000 in Europe and more than 2,000 in Australia, you can imagine the size of the market in China,” Gu told Shanghai Daily.

But for use of his robotic therapists in private homes, the mechanical devices have to be made more intelligent and affordable.

Gu is undaunted by challenges. He dreams of the day when robots can be used in general patient care.

By analyzing data from existing patients and through data-mining powered by new algorithms, he said future robotic products will become more adaptive to the requirements of users.

His company slogan says it all: “robotics for all.”

Future business models may include robots for short-term rental by patient. For people with Parkinson’s disease, permanent neurological damage or serious cognitive handicaps, a one-off purchase may be required for long-term help.

Gu’s vision doesn’t end at the border. He has already taken steps toward globalizing his operations. A subsidiary – the first of its kind by a Chinese robotics company – was recently opened in Singapore.

As the first Chinese robotics company to acquire approvals from the US and EU food and drug authorities, Fourier has had to overcome many hurdles. Gu said “made in China” products still carry a certain stigma in some foreign markets. That means Fourier’s products are often held to higher standards of quality control than similar products from Western suppliers.

Price factor

Fourier is intent on making products that “stand up to the harshest scrutiny,” Gu said. “We have to tread carefully and make few mistakes.”

He predicted that the Trump administration's increased tariffs on Chinese imports, especially high-tech products, will have only a limited impact on his business.

"Foreign-made robots are often more than twice as expensive as similar ones made in China," he said.

Recent developments are encouraging. His robots have made their way into the US market, arguably one of the most difficult, and into markets in Europe and Southeast Asia.

Gu said collaboration with Phoenix-based Barrow Neurological Institute, an internationally recognized leader in neurological research and patient care, is one of his most prized achievements.

He said the staff at Barrow were astonished to see cutting-edge, artfully-designed Chinese rehab robots priced at a 10th of the cost of Swiss or German models.

His confidence about the future of the company hinges on faith in China’s ability to swiftly absorb the most advanced technology and leverage the nation’s highly developed supply chain. A robotic prototype that takes three months to build in the US is only a week’s labor in China, he explained.

His plan for this year is to sell his robots in up to 20 countries and expand manufacturing capacity to 5,000 units – almost 10 times as fast as major rivals in Switzerland and Germany.

At home, Gu said he expects government authorities to break down the notorious “silos” that prevent hospitals from sharing information about patient medical plans.

At present, patients in public hospitals are mandatorily discharged after two weeks of treatment, and continued referrals between hospitals undermine the effectiveness of patient care.

Gu said the government should foster a more efficient referral system, so that patients discharged from Class-A hospitals feel more comfortable about being transferred to a secondary or community hospital.

“If the government institutes a pilot scheme encouraging all public hospitals, community rehab centers and nursing homes to use therapy robots, it might weave together a systemic healthcare network that works efficiently for rehab patients,” he said.