Clinical Need

SMA is genetic disease which results in a decrease in the production of SMN, which in turn leads to the death of motor neurons. SMA 0 - II are very severe pediatric conditions with high mortality rates, where as SMA III patients can live into adulthood and will be able to walk unaided for longer than other SMA types, but will need a wheelchair later in life.

SMA III will effect all of the musculature in the body, one of the most devastating for independence and quality of life being the upper body and hands. Loss of the use of ones hands severely hinders their agency.

Based on the prevalence study discussed in the epidemiology section, the frequency of SMA in the US is 8.5 to10.3 per 100,000 births. Since SMA 0-II patients are typically in a state that is too critical for physical therapy to be a viable solution and SMA IV patients tend to have comparatively mild symptoms, we will instead focus on SMA III patients. There are between 3592 and 4352 SMA III patients in the USA, with 41 to 50 more being born per year. The market of focus for us is the therapy that is used in tandem with the pharmaceuticals rather than direct competition with the drugs themselves. Most treatment regiments suggest a combination approach, so while the pharmaceutical market is very large it is not currently in competition with our market. The typical cost of a physical therapy session is $125.[4] Patients who are seeing a physical therapist for a prolonged period would typically have three appointments every week.[5] This results in an annual cost of $19,500 per patient or an annual market size between $70,044,000 and $84,864,000.

According to doctor Teresa Bisson, our clinical advisor, the philosophy of hand physical therapy has undergone a small revolution in recent years.

“For years people assumed that if you gave patients simple building-block exercises, that the ability to do complex tasks would improve as general proficiency in Range of Motion, Strength, and Endurance improved. However, what we have discovered in more recent years is that the best way to train patients to do these complex tasks is to have them do them or mimic them as best they can and use these as exercises.” - Dr. Teresa Bisson

Based on the philosophy of mimicking real to life motion and exercises, the idea of using Virtual Reality to guide, engage, and assess hand physical therapy patients became a effective and novel solutions. Our task was to create a prototype of hardware that could aid in this goal.