Recent years have seen rapid applications of the newest biological, information and manufacturing technologies to high-end medical devices. Medical robots, a typical example of such devices, have now become a high-profile favorite in the capital market, enjoying a promising future. As estimated by the Boston Consulting Group, the annual revenue of the medical robots market is US$4bn, and will reach US$11.4bn in 2020.

Medical robots are not a new topic. The strengths of both artificial intelligence and robots have enabled medical robots to develop at an accelerated pace, and gain an edge over even the most professional and hardworking medical workers, in terms of speed, accuracy, repeatability, reliability and cost effectiveness.

As an important member of the medical robot family, rehabilitation robots are now finding increasingly extensive applications in the medical market. The industry of rehabilitation robots is still being incubated and facing many technical barriers. Yet against all odds, Shanghai Electric has pioneered the era, always staying ahead of the curve.

Building up the Group's smart healthcare eco-system in the future

In June 2018, Shanghai Electric Intelligent Rehabilitation Medical Technology Co., Ltd. ("Intelligent Rehabilitation") was established against the backdrop of Shanghai Electric Central Academe being positioned as a Technology and Innovation Group. As a holding subsidiary under Shanghai Electric Group, Intelligent Rehabilitation is committed to researching cutting-edge rehabilitation technologies for the Group, promoting scientific cooperation and commercializing the scientific achievements, and building the Group's smart healthcare eco-system in the future.

As a company committed to high-end rehabilitation medicine, Intelligent Rehabilitation provides rehabilitation robots and smart healthcare solutions, by harnessing the extensive expertise and remarkable achievements of the Central Academe in the field of automatic mechanization, and cooperating with famous universities and hospitals in China to achieve industry-academia-research integration.

From an experimental project to its establishment as a company, Intelligent Rehabilitation has undergone a long process of commercializing its technological achievements.

As early as 2013, Shanghai Electric launched the research and development of key technologies for rehabilitation robots, and focused on upper- and lower-extremity rehabilitation robots. As important applications of mechanical automation to the medical field, rehabilitation robots will have great market potential in an increasingly aging society in the future.

Early that year, the Robotics Research Laboratory was established, and an experimental study focusing on mobile lower-extremity rehabilitation robots was started. Relative to stationary rehabilitation in traditional solutions, mobile lower-extremity rehabilitation robots can help the patients with body displacement during the rehabilitation, making the rehabilitation more flexible to some extent. However, during the research, the team also found that once put into use, such products would pose big challenges to the current hospital management, such as with respect to space management.

Shanghai Electric Group has placed a high emphasis on the R&D of rehabilitation robots, an emerging industry, aiming to realize intelligent rehabilitation. Rehabilitation robots make rehabilitation treatment safer, helping rehabilitation physiotherapists carry out rehabilitation training for patients, reduce their labor intensity, and address the shortage of medical personnel and institutions for rehabilitation.

In 2015, the Laboratory began research on fixed-base robots for lower-extremity rehabilitation, for the purpose of upgrading the traditional fixed-base products, which did not allow spatial movement to a large degree for users, and thus restricted their interactive spaces to a certain extent.

In 2016, the prototype of the upper- and lower-extremity rehabilitation robots was developed. It took three years of R&D efforts for the Laboratory to complete the research into portable robots and fixed-base ones, through trial and error for machinery, control, and sensing systems. Later on, in 2017, the rehabilitation robot product room was established, and the product performance was further improved on the basis of the prototype.

In 2018, Intelligent Rehabilitation was established, opening a new page for the rehabilitation robot project, while transferring the research achievements from the ivory tower to the market. In the emerging medical rehabilitation device industry, the team at Intelligent Rehabilitation is facing uncertain opportunities and challenges. The high technical threshold in the field of rehabilitation equipment makes innovation a must to survive in the market. Innovation is an intrinsic requirement amid the dramatic changes in the era, and has been the basis upon which Shanghai Electric has been established. Therefore, Intelligent Rehabilitation has put innovation at the core of its DNA since its founding.

Rehabilitating patients using innovative technologies

Nerve damage often leads to movement disorders, such as those of stroke. Rehabilitation training can help restore the patients' mobility to some extent. As we all know, rehabilitation training is a repetitive and time-consuming process, which is physically demanding on physiotherapists.

Spanning a variety of disciplines such as robotics, movement biomechanics, ergonomics, and mechanics, rehabilitation robots can relieve physiotherapists of repetitive manual work. In addition, with the development of intelligent technology, the robot-assisted rehabilitation training can not only accurately and effectively control the rehabilitation process, but also collect the rehabilitation data.

Through 5 years of R&D effort, Shanghai Electric has obtained important research outcomes, in terms of biomechanics-based exoskeleton mechanism design, weight reduction through dynamic structures, and the quantification and evaluation of rehabilitation strategy parameters. Nearly 30 patent applications and a number of software copyright applications have been filed. Now the product lineup includes "the upper-extremity rehabilitation training and evaluation system (upper-extremity rehabilitation robot), lower-extremity gait training and evaluation system (lower-extremity rehabilitation robot), portable wearable exoskeleton upper-extremity rehabilitation robot, mobile lower-extremity rehabilitation robot," and so on.

The company has developed a variety of products such as the upper-extremity rehabilitation training and evaluation system (upper-extremity rehabilitation robot), weight reduction gait training and evaluation system (lower-extremity rehabilitation robot), and mobile lower-extremity rehabilitation robot. Among them, the upper- and lower-extremity rehabilitation robots are positioned as high-end rehabilitation products. The two products were showcased at the 22nd China (Shanghai) International Medical Devices Exhibition 2018 and the 12th International Convention on Rehabilitation Engineering and Assistive Technology (i-CREATe 2018), and attracted the attention of many professionals in the medical field.

The lower-extremity rehabilitation robot (NaturaGait 1.0) features a fixed-base mechanical structure. The product is designed to provide patients with more freedom of movement, more considerate rehabilitation training, as well as a better patient experience.

For example, the pelvic weight-reduction structure frees the upper extremities from being restrained by the equipment and harness during lower-extremity training, bringing more free and relaxed rehabilitation experiences to patients, as compared with the weight-reduction suspension structures previously imported.

As mentioned above, rehabilitation training is a continuous, repetitive and monotonous process, during which many patients are under great psychological pressure. So what can be done to make the process more pleasant? After repeated verification, the engineering team added a virtual human-computer interaction feature to the product. The simple and fun game incentives help alleviate the psychological stress of the patient during rehabilitation.

The product also comes with a fall prevention mechanism to offer comprehensive safety protection for patients with limited mobility. When a patient shows any signs of falling, the system will protect the patient through automatic control of the height of the body position. In addition, the rehabilitation plan can be customized according to the conditions and vital signs (height, weight, etc.) of the patient to meet the different needs of each patient.

The upper-extremity rehabilitation robot (Flexo-Arm1.0) also employs a fixed-base structure, which enables continuous movement with multiple degrees of freedom during rehabilitation training, tailored to patients in different rehabilitation stages.

Besides, the upper-extremity rehabilitation robot offers a variety of movement modes (active, passive, etc.) in the system to rehabilitate patients in different stages. For example, patients in the early stage of rehabilitation should select more passive exercises, while for those in the late stage of rehabilitation who have undergone very successful training sessions, active or resistance training is needed to increase the difficulty.

To better the patient experience in the rehabilitation process, the upper-extremity rehabilitation robot also adopts an "integrated design for both hands." It allows the patients to alternate between training their left and right hands by sliding, and accordingly, the more compact equipment also makes the operation more flexible.

Both the upper- and lower-extremity rehabilitation robots are equipped with intelligent rehabilitation systems, allowing real-time transmission of all patient data to the cloud for big data analysis, so doctors can track and evaluate the long-term rehabilitation effects of the patients.

Becoming a pioneer in the rehabilitation industry

Rehabilitation robots involve various technical fields, such as biomedicine, mechanical engineering, electronics, computers, and new materials. Moreover, with the rapid and continuous development of IoT technology and intelligent hardware devices, intelligent and informatized rehabilitation robots will be a major trend in the medical rehabilitation industry in the future. However, in general, the industry is still in the early stage of development, that is, the lead-up to explosive growth. For example, rehabilitation robots are still in the R&D stage, with no leading companies cornering the market. We will usher in a fast-growing golden period. In the future, Shanghai Electric will accelerate the transition from traditional manufacturing to intelligent manufacturing, striving to industrialize rehabilitation robots.

It is expected that by the end of 2019, the upper- and lower-extremity rehabilitation robots will be launched to the market after being registered with the CFDA, so as to provide rehabilitation training for patients with nerve injuries such as stroke. Currently, relevant teams at Shanghai Electric Group have begun working with various medical institutions to learn about the market demand.

From a global perspective, rehabilitation robots have been studied for over 50 years, mainly in Europe and the United States. A technological latecomer as it is, China is poised to register a phenomenal growth as driven by the demand surge. At the same time, China is intensifying efforts to implement relevant policies in support of the rehabilitation industry. An increasing number of rehabilitation items will be included in the medical insurance, which means that the ultimate obstacle to the industrial development will be overcome.

Opportunities and challenges coexist in the "blue ocean" rehabilitation industry. Supported by relevant polices and driven by market demand, Intelligent Rehabilitation will continue to focus on its values of "dedication," "innovation" and "collaboration." It will dedicate itself to the field of medical rehabilitation, provide comprehensive and intelligent medical rehabilitation solutions through technological and market-based innovation, and build a collaboration platform for various players in the field to enable more patients to live healthy lives, in a bid to become a leading pioneer in the Chinese intelligent rehabilitation industry.