Imago Rehab: Breaking New Ground in Stroke Recovery

By Mark Ogilbee posted 04-20-2023 06:57 AM


Based in the Boston area, AgeTech Collaborative™ startup participant Imago Rehab is developing a robot-assisted virtual clinic for stroke recovery. Combining telehealth occupational therapy sessions with a robotic glove that facilitates daily, high-repetition hand rehabilitation, the company is helping stroke survivors with hand impairment use their hands again. 

Co-founder and chief clinical officer Kristin Nuckols spent some time with us describing how Imago Rehab's tech and protocol is disrupting the stroke rehabilitation space.  

This interview has been edited for clarity and length. 


Can you tell us about Imago Rehab? 

We’ve developed a soft robotic glove that assists people who have had a stroke move their hand hundreds of times a day, which is necessary to make motor recovery happen. It’s not on the market yet, but people will be able to use the device at home. We also offer innovative, effective and billable telehealth occupational therapy for adults who have had a stroke. 


Does the glove help the person actually move their hand, or does it translate the movement they are capable of into greater dexterity? 

There’s this question in the rehab world: Do you try to restore movement that is lost? Or do you provide assistance that can supplement the limited movement to help with daily life? 

Our glove does both, but we have more of a rehabilitation focus. People need to move their hand — but they need to try to move their hand. The glove feels that effort and moves with them. If they have no movement, the glove can impose movement on them by pushing their hand open and closed comfortably, and they can get lots of repetition and practice moving that way. 

But rehabilitation isn’t passive: I can open and close your hand for you, but that won’t magically make things better. You have to actually think about it and try to move. Our glove senses those intentions and helps them move. 


How does the glove actually work? 

There are chambers inside the glove that are essentially balloons. They inflate and deflate to make your fingers straight or to push them closed. There’s a sensor that reads your attempt at movement and tells the system what to do and when to do it. 


Are there scenarios where the glove can be helpful, other than for those who have had a stroke? 

We originally came out of Harvard engineering lab; when we were there, we also tested in populations with muscular dystrophy, ALS, and spinal cord injury. It could also be very helpful for children or adults with cerebral palsy, and potentially people with arthritis who need to do motion exercises in a comfortable way. So there are a lot of applications that we haven’t explored yet. 


Why are you focused on helping people recover from a stroke in particular? 

Partly because I’m one of the co-founders, and I’m an occupational therapist with 16 years’ experience using evidence-based procedures to work with adults with stroke. But also because there are five million stroke survivors in the U.S. alone, and that number grows by 800,000 people a year; it’s one of the leading causes of disability in the U.S.  

The thing that makes a person’s stroke symptoms decrease is active use. Some people say that a stroke survivor's leg recovers better. If that’s true, it’s because a person still has to stand up to get dressed and do other daily activities, like getting into the car. They use their brain and their leg many times a day, so they establish a better connection. 

But while it is difficult to do tasks in your daily life without one of your hands, it's not impossible — so people are able to ignore their hand or not use it. It becomes a cycle: They don’t use it, so it gets worse, so they don’t use it, and it gets worse. It’s called the cycle of learned nonuse. We want to break up that cycle by giving them a reason to move and the assistance to move. 


Can you tell us about the telehealth side of Imago Rehab?

The glove is only part of our treatment protocol, because the device isn’t going to fix the problem — behavior does. It’s a behavior-changing treatment plan.  

The telehealth component is part of our special sauce, because we find that therapy needs to happen outside of the clinic. You can do therapy twice a week in a clinic, but if nothing changes at home, it’s not going to be effective. 


Does your treatment protocol offer any special benefits for those who are 50-plus? 

Telehealth really opens up the world of rehab. You don’t have to drive anywhere, or get someone to drive you. And those who live far from a metro center might not have an appropriate clinic nearby, anyway; people recovering from stroke need to be seen by clinicians who have certifications and training in the techniques to treat people. Not every clinic can provide excellent stroke car. 


What are some of the problems you’ve encountered as you’ve grown Imago Rehab? 

Every day is a learning experience. I have a bunch of tasks ready to go for the day that are all things I’ve never done before, so every day the learning curve is steep — and that gets a little bit exhausting. And the task of raising venture capital and angel funding was challenging because this is a hard time for the tech world, and things are a little rough financially. 


What are the next steps for Imago Rehab? 

We’ve been established in Massachusetts for almost two years as a telehealth business, and we’ve expanded into Virginia. Now we’re looking at expanding into a third state and figuring out where that’s going to be. It will certainly be a state with a lot of seniors, because we want to establish ourselves where people need our services.  

One reason I got into this business is because the research into stroke rehabilitation says that people should get a lot better than what we see in everyday practice. Imago Rehab is really different than other therapies people are used to experiencing; no one’s ever done therapy like this. So I would encourage adults who are recovering from a stroke to give us a call or visit our website to see if Imago Rehab can be part of their journey. 

Visit Imago Rehab's website to learn more.