Orthotics/Prosthetics

Before Brian Glaister, MS, PhD, became president and chief executive officer of Cadence Biomedical, he was a frustrated graduate research assistant at the VA Center of Excellence for Limb Loss Prevention and Prosthetic Engineering in Seattle. Glaister — armed with a master’s degree in bioengineering from Arizona State University and an internship with Prosthetic Orthotic Associates in Scottsdale, Ariz. — was not frustrated by the work. In fact, he loved his job and had a strong passion for it. At the VA, he was developing robotic prosthetic limbs for amputees, which he found fascinating and enlightening. The problem was his subjects would routinely ask when they could receive the robotic limbs he was developing.

“Unfortunately, the answer was probably never,” Glaister told O&P Business News. “More than likely, I was just working on an academic project. I was working really hard on these projects. I thought if I was working this hard, I might as well try to get it out there and help people.”

Fast friends

Jason Schoen received his bachelor’s degree in bioengineering from Marquette University. At Marquette, he had an advisor with an O&P background and Schoen was intrigued by her work. He enrolled in O&P classes while working at a human motion lab conducting gait research. Schoen also worked at the Froedtert & Medical College Stroke Program at the Medical College of Wisconsin.

“I worked on creating stroke rehab technologies for home therapy,” Schoen told O&P Business News. “I generally focused on low cost devices.”

After graduating, Schoen moved to Seattle to work for the VA Center of Excellence for Limb Loss Prevention and Prosthetic Engineering conducting human motion and prosthetics research.

Glaister also had experience working with and researching highly functional, low-cost items. For his required research project, Glaister performed a biomechanical study comparing the Jaipur foot, an inexpensive, rubber-based prosthesis developed in India that could be quickly manufactured and fit, to more expensive lower extremity devices.

“I met Jason when he took a job at the Seattle VA,” Glaister said. “I had been working there a few months as a graduate research assistant and we instantly became fast friends. We were both looking for something more out of our careers. I distinctly remember picking Jason up from the airport and telling him I wanted to start a company. It didn’t take much convincing.”

 

Company growth

With Schoen on board, Glaister officially founded Cadence Biomedical, originally named Empowering Engineering Technologies, Corporation (EET) in August 2007. Living in Seattle, which is essentially a startup community, Glaister leaned on the advice of colleagues and friends who had experience maintaining a small business. Schoen and Glaister regularly met on Monday nights after work in Glaister’s dining room in Seattle writing grant proposals, brainstorming product ideas and discussing possible challenges and hurdles to the business. Meetings at Glaister’s house were upbeat with a very collegial atmosphere.

“It was important to foster that early on,” Glaister said. “Who would spend their free time working on things if it wasn’t fun?”

At the end of each meeting, Schoen and Glaister created a list of tasks that they were to work on for the next week. The grant proposals were continually coming up empty, but Glaister kept writing and maintaining contact with possible investors.

In 2008, Chie Kawahara, BS, MS, joined Schoen and Glaister, forming what would become the full team of Cadence Biomedical. Kawahara earned a master’s degree in biomedical engineering from the University of Michigan. One of Kawahara’s lifelong friends was a colleague of Schoen and Glaister at the Seattle VA. Schoen and Glaister were looking for additional engineering help when Kawahara’s name came up.

“At the time, I was working on a few different projects,” she told O&P Business News. “My background is in electrical and biomedical engineering. I worked in the medical device field my entire career, not O&P. But it was really great to sit around and spend time working on projects from the ground up. We spent a lot of days hanging out and brainstorming. That was the initial appeal.”

 

Breakthrough

While the team continued with various projects, Glaister was contacted by A.J. van den Bogert, PhD, department of biomedical engineering at the Cleveland Clinic.

“He had the idea that if you put a long spring on a human it may make them as efficient as a horse,” Glaister said.

According to Bogert’s research, of the seven musculotendinous structures in the distal part of the equine hind limb, four were almost completely tendinous and the others have short muscle fibers with strong parallel elastic tissue and a long series elastic component spanning up to four major joints.

“This limb design results in various ‘pogo-stick’ and ‘catapult’ mechanisms that contribute to efficient locomotion,” Bogert wrote in his study. “Consequently, horses consume 50% less metabolic energy for running than humans, per kg of body weight.”

There was computational work that showed that his theory had merit, but Bogert did not know how to build the exoskeleton using pogo-stick mechanisms or who it would be good for. Although they were working on a number of ideas at the time, the Bogert research had the most potential for success.

“We licensed the patent and started working on it,” Glaister said. “The rest is sort of history.”

The Kickstart prototype

Glaister likes to say that Schoen lived in his basement for the better part of the winter of 2009 and into 2010. Schoen did not actually live in his basement but he spent most of his free time there building the first kinetic orthosis prototype out of spare parts using essentially a handsaw and a Swiss army knife. The idea was that the kinetic orthosis would provide stability to weakened muscles using a tuning system of springs and cams to capture energy typically wasted during the beginning of a step. The device would then return the energy at the end of the step, propelling the user forward. The user’s leg would lift in preparation for the next step. The device was aimed for users with severe weakness in their legs such as stroke victims and users with partial spinal cord and brain injuries.

That winter, the team flew to Cleveland to get some rudimentary data to demonstrate the device’s potential.

 

“I think when we started off, we were all working on everything,” Kawahara said. “There was so much to do. We didn’t have the structure figured out yet. But as we’ve grown, we have taken our own roles.”

The team came together on the big decisions but each member had their specific roles as well. Glaister was the head of the company, writing grant proposals and generally doing everything he could to drum up interest. Schoen was the developer, working long hours to create prototypes of the kinetic orthosis. Kawahara worked on the company’s operations as well as helping Schoen with the engineering and development.

Under pressure

Sometimes the money is spread entirely too thin. Sometimes the good ideas fail. Inspiration dissipates and frustration turns to uncertainty or self-doubt. In early 2010, EET was at the point where it could begin to attract investors, but Glaister’s proposals were still being denied.

“I think at different times we had moments where we had doubts, but I think we were a good team because we were never discouraged at the same time,” Kawahara said.

In order to start attracting investors, Glaister had to prove in high pressure pitch meetings with potential investors that the product could provide a positive impact for individuals with lower extremity impairment. By August 2010, the team was able to get two small grans from the Army and closed an early investment round. Cadence Biomedical had enough money to move out of Glaister’s basement and into an office full-time.

The team created a robust beta prototype that could be adjusted to whoever walked through the door. Stroke victims and partial spinal cord injury patients of different levels of impairment were able to try the device.

“There is always uncertainty, especially when we were running out of money,” Schoen said. “There are periods when we are working an unbelievable amount and it gets frustrating. I think that we are working on a product and in a field that has very measurable outcomes. Every once in a while it is easy to get bogged down. But we have also seen people use our device and when you can see the difference it can make for people, it is easy to stay motivated.”

In 2011, Glaister pitched the device to HealthTech Capital co-founder, Don Ross. Ross’ wife had suffered a debilitating stroke. Ross told Glaister that if his wife liked the device, he would be interested.

“She became an angel investor,” Glaister said. “She liked the device so much that she joined our board of directors.”

In that same week, two of EET’s grant proposals were accepted, including one from the National Institutes of Health. Cadence Biomedical had enough money to move out of Glaister’s basement and into an office full-time.

What’s next?

In late April, Cadence Biomedical announced the closing of $1.1 million Series A2 financing. The financing will support manufacturing and sales of the Kickstart, the latest version of the kinetic orthosis originally created in Glaister’s home. There is no firm date yet, but Glaister is hoping to make Kickstart commercially available by the end of June. He is also looking to add talent to his tight-knit team.

“When we see someone use Kickstart and we see their excitement, those are the breakthrough moments that stand out for me,” Kawahara said. “That is when I know we are doing something meaningful.” — by Anthony Calabro

For more information:

Timmerman, L. Cadence biomedical snags first $1M to help disabled people walk. Xconomy. Available at: http://www.xconomy.com/seattle/2012/01/18/cadence-biomedical-snags-first-1m-to-help-disabled-people-walk. Accessed: May 9, 2012.

Van den Bogert, AJ.Exotendons for assistance of human locomotion. BioMedical Engineering Online. doi:10.1186/1475-925x-2-17.