Publicly listed global medical device company Penumbra has expanded its portfolio to include virtual reality offerings through its REAL Immersive System in 2019. The system is designed to help physicians meet the individual needs of patients in a rehabilitation setting.
The company then expanded its virtual reality offerings with the REAL i-Series in 2021, bringing immersive vision-based experiences to healthcare providers and mental health professionals. Earlier this year, he released his y-series, which focused on physical and cognitive rehabilitation.
Adam Elsesser, President, Chairman and CEO of Penumbra, joined MobiHealthNews to discuss Penumbra’s REAL System offerings and how the platform is changing therapeutic rehabilitation.
MobiHealthNews: Why did you decide to expand and enter the field of virtual reality?
Adam Others: It is relatively simple. We never saw ourselves in the Penumbra as others like to categorize us. We started as a stroke business – then when we got into the peripheral side, you know, the rest of the body. It was, “Well, wait. I thought you were a stroke company.” We have never been limited to this kind of reflection. We see it as a simple thing. If there are people suffering from some form of disease and we think we can find a solution, that’s kind of our mandate. We happened to start with a stroke. This was something we understood relatively well and we thought we had a solution. We moved to the rest of the body for the same reason.
We are not a technology company. We’re not particularly enamored with the idea of VR outside of that use. However, it is really a single tool to help people with a fairly wide range of conditions.
MNH: You said it treats different conditions. What conditions does the REAL system treat?
Elsesser: We initially focused on rehabilitation after a stroke, which we knew quite well. [We] understood how the brain interacts after a stroke, what neuroplasticity is, and how you can help encourage and benefit from neuroplasticity with a virtual reality tool. Then we realized that means it can do a lot of different things beyond this particular use case, in other forms of physical rehabilitation – where you’re actually encouraging movements that are otherwise difficult or not fun or uncomfortable – and in purer forms of mental health domains such as stress reduction.
MNH: Can you tell me how the REAL System works?
Elsesser: It uses the tool of virtual reality – the idea that you put on a headset and are, in effect, transported to another place. We have different versions, depending on the medical condition.
So we have the y-series, which is the ability to see and follow your body in this experience. This is specifically designed for things in the rehabilitation field, but will expand to other applications where seeing your body allows you to be more engaged and potentially have a deeper ability to interact with any experience, but on top of that. all, if you need to know how the move is going. Do you raise your hand? From which angle? What kind of rotation? You can measure all of this very accurately with our proprietary sensors. They are not based on optics. It’s not the typical stuff you see in everyday commercial headphones that are available.
And then we have a single headset without any sensors, or even any controllers. It’s all based on sight, so people in other environments, who may have limited movement in their hands or their grip isn’t there, don’t have to think this way. They can just control it with their head. And usually, we call it the i series, for more mental health applications.
MNH: How do these systems help therapists do their work?
Elsesser: Let’s say you had a stroke and lost mobility or partial mobility on the right side of your body. Let’s just focus on your right arm, for example. In order to start regaining movement on the right side of the body, we do rehabilitation. Rehab is simply repeating movement as much as you can to retrain the brain. The reason you can’t move your arm after a stroke is that the brain tissue that controls this movement is no longer viable. The attack brought him down, if you will. So the basic principle of neuroplasticity is that you can put that function somewhere else. You can retrain another part of the brain to perform this function, but it’s hard work and not everyone can do it. It is extremely tiring. And doing it in virtual reality is easier thanks to the function. You can trick your brain faster.
The therapist controls the rehabilitation session. So there is a tablet that comes with it. And this tablet has two parts. The first is that all exercises are controlled by the therapist. They choose which one to use and also check, as part of the exercise, what happens. Plus, they see what you see on their tablet. So they’re all online and at the end they get a report that measures all those moves, and they can look at it and see how you did compared to what you did last time and the time before that. So it’s really designed for the patient, but it’s also designed with a lot of the therapist in mind.
The key here is not to get rid of therapists. I think sometimes people think that technology is trying to replace the therapist. The therapists are amazing and eventually we will have a version at home that the therapist can control as well where you can experience it remotely. But even then, the therapist can give people homework that they check. So it’s not like they wear it and play, but they do the exercises that the therapists can watch and see the data about your movement. Everything is recorded. It is truly a health care oriented tool.
Our goal here is, and I think it’s really key and it’s probably clear from what I’ve said before, we don’t believe in virtual reality or immersive world as an end. There are companies – I will not name them [whispers Meta or Facebook] – but they believe that you have to live in this fake world forever, because then you will spend money and make money, and they will control everything you do. It is unusual. I won’t do it. I don’t think most people will. That’s not the point. Our goal is to help you live in the real world as quickly as possible. And that’s why we named the product the REAL System, because the goal is to live in the real world and use it only as a therapeutic tool to get back to the real world. And it’s really important to say that because I think, unfortunately, the power of this technology has kind of gotten mixed up with all this other nonsense, and I think it’s important to highlight this really differentiating point of important.