‘Mobile therapist’ technology shows promise in helping cancer patients regain ability to swallow

U of A rehabilitation medicine researcher gains entrepreneurial experience as Mobili-T device hits the market.


True Angle Medical Technologies co-founders Jana Rieger (left) and Dylan Scott, pictured in 2019. The spinoff company's Mobili-T technology hit the U.S. market this fall, and has already been described as a "game changer" by clinicians using it to help cancer patients regain the ability to swallow. (Photo: Faculty of Engineering)

University of Alberta researcher Jana Rieger was uneasy when she realized her team’s pocket-sized invention to help cancer patients regain their swallowing ability needed to move beyond the lab into the marketplace.

“It was like sitting on the edge of a valley and I could see the other side, but it seemed like a big jump—it was a whole new world; I was so used to academia and I knew how to function in that world, but I didn’t know very much about the entrepreneurial world.”

That was in 2017. Fast-forward to this fall, as the exercise device, called Mobili-T, hits the market, and she’s now feeling much better about the whole venture.

Being able to successfully straddle the worlds of research and business “has been one of the greatest things in my life,” said Rieger, a professor in the Faculty of Rehabilitation Medicine, who not only led development of Mobili-T, but is also co-founder and CEO of True Angle Medical Technologies Inc., the spinoff company that developed the device.

Born as an idea in Rieger’s lab in 2013 with co-founders and research colleagues Dylan Scott and Gabriela Constantinescu, Mobili-T is now available to the U.S. market and is being used by speech language pathologists to help their patients with swallowing impairments.

True Angle co-founder Gabriela Constantinescu demonstrates how the Mobili-T device works with a mobile app to guide the user through swallowing exercises.


Mobile therapist saves trips to clinic

Mobili-T—short for mobile therapist—is one of a kind; the only mobile, home-based swallowing exercise device available that pairs real-time visual biofeedback with a smart software-based coaching system, all while maintaining a direct connection to the speech language pathologist, who can, for the first time ever, reliably track a patient’s progress.

The wireless piece of hardware senses muscle activity when placed under the chin and gives patients direct feedback about swallowing muscle activation. An app that provides real-time biofeedback on a mobile device, like a cellphone, leads patients through swallowing exercises. 

The invention lets people do intensive exercise at home instead of having to carve out time from their jobs and daily lives to come to a clinic, where they have to use a machine about the size of a refrigerator.

The venture also created at least 10 different high-tech jobs at various points, and True Angle has a core staff of seven people, with sales and marketing positions opening up now that the product is on the market. The company, which Rieger predicts will double in size next year and again after that, also plans to bring in more scientists to improve the software and integrate machine learning.

“It’s a good feeling knowing that Mobili-T is now on the market, with the potential reach to help many people,” said Rieger, who is also director of research at the U of A Institute for Reconstructive Sciences in Medicine.

“As clinicians, we tend to feel we’re never doing enough for the patient, and this provides a way to help patients beyond standard exercise handouts. This goes so much further; if we know they’re doing 80 per cent of their exercises at home, and we’re able to introduce four new foods into their diet, what happens if we can get them to do 90 per cent of their exercises? This device helps us understand that progress.”

Personalized approach

Swallowing disorders change a person’s life, she said. 

“There's daily fear of eating a meal because they could choke and die, and that’s if they can eat a normal meal. A lot of people have to blend their food, and when it’s really bad they may have to drink a liquid supplement or rely on a stomach tube.” This can mean embarrassment and social isolation as their friends become uncomfortable watching them struggle to eat. 

“There’s this emotional loss.”

Mobili-T’s sophisticated software offers a personalized approach to health, Rieger noted. The device can help people set targets for their daily exercises, by sensing their muscle energy levels and setting realistic goals. “It lets people work to their own ability.”

Having at-home intensive exercise saves patients money, helps them socially distance during the pandemic and could help them eat food more safely or get off feeding tubes, she added.

Mobili-T went through several prototypes at the hands of a team of therapists, patients, computer programmers, industrial designers and engineers, including from the U of A faculties of arts, engineering and rehabilitation medicine, before being refined to its current form, about half the size of a key fob.

Patient trials began in 2017, and a feasibility study with the device over six weeks showed improvement with the majority of participants. 

“There wasn’t as much coughing, it was easier to swallow, it didn’t take them as long to eat and they were less embarrassed socially,” Rieger said.

Next steps

Rieger next plans to monitor Mobili-T’s benefits over the long term, including studies with stroke patients to see whether the device can help them, too. 

“We will learn more about how this technology can change people’s lives. We know there are benefits to the body to doing any kind of exercise for a longer amount of time, and we theorize it will be the same here.”

Mobili-T, which Rieger hopes will be on the Canadian market by the end of 2021, is already getting good reviews from purchasers in 11 states, after just one month on the market.

“Clinicians using it in the U.S. have called it a game changer, and that tells me there's been a desperate need for an elegant mobile solution for this kind of program.”

Tackling the business side—from understanding their specific market to attracting investors—was a learning curve for Rieger and her team, but it also shows how research and commercialization make good partners, she believes.

“Businesses are starting to get into the health-care space, big businesses like Apple and Amazon. They’ll have attractive platforms that patients want to use, and where they’ll upload their data. Innovation will come from researchers who will use those data to learn about outcomes in relation to interventions.

“The ability of business to bring in patient customers and the ability of researchers to do something useful with their data is how they will lock together.”

Mobili-T research and development was supported at various points by the Canadian Institutes of Health ResearchNatural Sciences and Engineering Research Council of CanadaNational Research Council Canadathe Alberta Cancer FoundationAlberta Innovates and the Glenrose Rehabilitation Research, Innovation and Technology program.

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