1:51pm

Tue May 13, 2014
Shots - Health News

A Spoon That Shakes To Counteract Hand Tremors

Originally published on Wed May 14, 2014 9:43 am

Eating a bowl of cereal in the morning seems like such a simple thing, but it's close to impossible for some of the 1 million Americans who struggle with the tremors of Parkinson's disease.

There are also as many as 10 million Americans who have a disorder called essential tremor — sometimes mistaken for Parkinson's — which, when severe, also can make eating a struggle.

That's obvious when Joe Bremhorst tries to eat a bowl of Cheerios. His essential tremor is so strong that the cereal bounces right out of his spoon and back into the bowl. No Cheerios make it as far as his mouth.

This is the problem that engineer Anupam Pathak wanted to solve. He couldn't cure Bremhorst's tremor. But he could develop a spoon that would cancel out its effects. He calls the spoon Liftware.

There's no on switch; the spoon starts up automatically when it's lifted from the table. The chunky handle vibrates a little in the user's hand.

"There's a little motion sensor right near the spoon," Pathak explains. "If I had tremor, it's going to move opposite to what the shaking is doing. So, if I move to the left, it'll physically move the spoon to the right."

And that cancels out the tremor as the spoon moves from plate to mouth. In a clinical trial, the Liftware spoon canceled out more than 70 percent of a user's tremor.

"I don't think it took us five minutes to say, 'This is remarkable,' " says Sheila Garner, who oversees two-dozen senior and assisted living facilities in Northern California run by Brookdale Senior Living. She was impressed enough with the Liftware spoon to order some for her residents with essential tremor.

"We'll be able to free up staff time from assisting people with eating," Garner says. But her focus, she says, is on restoring the dignity that her residents with essential tremor lost when they could no longer feed themselves.

Stabilizing technology has been around for a while. Steadicam, for example, is used to shoot movies. The Liftware device has to compensate for larger movements and still fit comfortably in the hand.

Pathak says he got the idea while still in grad school. "I was working on technologies for Army Research Lab ... to stabilize [rifles] for soldiers in combat," he says.

But that wasn't what really moved him. "I've always had this sort of drive," he says, "of wanting to make technologies with ... very personal and immediate impact."

You can see that impact when Bremhorst digs into the bowl of Cheerios with the Liftware spoon. Though his hand still shakes, he doesn't drop a single O. Bremhorst is part of an essential tremor support group that tested prototypes of the Liftware spoon. While he now has a brain implant that can control his tremor, he shut it off to participate in the tests.

The Liftware prototype was once a chunky thing with wires sticking out, and a plastic picnic-spoon taped to the end. Sharon Alexander, the facilitator of the support group, says members gave Pathak a lot of feedback.

The product became available commercially last December — and at roughly $300 (via the company website or Amazon), it's not cheap. Pathak wouldn't disclose exactly how many he has sold, but says it's more than 1,000.

So far Medicare and private insurance don't pay for the devices, but a handful of Veterans Affairs medical centers do. Meanwhile, Pathak has raised enough money on the Internet and through foundations to give away a couple of hundred spoons to people who can't afford them.

And soon there will be new attachments. A fork and a soup spoon should be available by the end of June. Devices for holding a door key steady and for grabbing small objects are on the drawing board.

"We want it to be kind of like a Swiss army knife," says Pathak, something to help stabilize the lives — and maintain the independence — of a lot of people with tremor.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

AUDIE CORNISH, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.

MELISSA BLOCK, HOST:

And I'm Melissa Block.

Eating a bowl of cereal in the morning seems like a simple activity, but it's close to impossible for some of the one million Americans who struggle with the tremors of Parkinson's disease. There are also as many as 10 million Americans who suffer from a disorder called essential tremor, which is sometimes mistaken for Parkinson's. Well, now a California engineer has invented an eating utensil that cancels out the uncontrollable shaking.

NPR's Ina Jaffe reports.

INA JAFFE, BYLINE: Joe Bremhorst sits at a large table doing something that most people take for granted. But his severe essential tremor makes eating a bowl of Cheerios nearly impossible.

JOE BREMHORST: So we're demonstrating now obviously the difficulty I have eating.

JAFFE: You're not getting anything out of that bowl.

BREMHORST: Nothing.

JAFFE: Just moving the spoon around.

BREMHORST: Yeah. And the closer I get to my mouth the worse the tremor gets.

JAFFE: This is the problem that engineer Anupam Pathak wanted to solve. He can't cure Bremhorst's tremor. Instead he developed a spoon he calls Liftware.

ANUPAM PATHAK: So you can kind of feel it gently vibrating. Those are the actuators inside.

JAFFE: I'm holding the chunky handle of the spoon at the San Francisco office of Pathak's company, Liftlabs. As he says, the handle of the spoon vibrates, slightly. There's no on-off switch. The device starts automatically when you pick it up.

PATHAK: And so, right now it's kind of sensing your motion and it'll respond.

JAFFE: It responds by moving the spoon that snaps onto the handle.

PATHAK: There's a little motion sensor right near the spoon. So if I had tremor, it's going to move opposite to what the shaking is doing. So if I move to the left, it'll physically move the spoon to the right.

JAFFE: Essentially canceling out the impact of the tremor, as the spoon moves from plate to mouth. According to a clinical trial, a Liftware spoon cancels out more than 70 percent of a user's tremor.

SHEILA GARNER: And I don't think it took us five minutes to say this is remarkable.

JAFFE: Sheila Garner oversees a couple of dozen senior and assisted living complexes in Northern California. She was impressed enough with the Liftware demonstration to order some for her residents with essential tremor.

GARNER: And certainly we'll be able to free up staff time from assisting people with their eating. But really, our focus is on the fact that this provides a level of dignity for residents with essential tremors that they haven't been able to have, because there isn't a utensil that would help them in being able to eat unassisted.

JAFFE: Stabilizing technology's been around for a while. You may have heard of the Steadicam used to shoot movies. But the Liftware device has to compensate for larger movements and still fit comfortably in the hand. Pathak says he got the idea while he was still in grad school.

PATHAK: And I was working on technologies for Army Research Lab. And we were working on ways to stabilize equipment for soldiers in combat.

JAFFE: By equipment, he means guns. But that wasn't what really moved him.

PATHAK: I've always had this sort of drive of wanting to make technologies with this sort of very personal and immediate impact.

JAFFE: An impact which you can see when Joe Bremhorst attacks that bowl of Cheerios with the Liftware spoon.

BREMHORST: Oh, these Cheerios are good, Anupam.

(LAUGHTER)

JAFFE: He doesn't drop a single one. Bremhorst is part of an essential tremor support group that tested prototypes of the Liftware spoon. While he now has a brain implant that can control his tremor, he shut it off to participate in the tests. At first, the device was a chunky thing with wires sticking out and a plastic picnic spoon taped to the end.

Sharon Alexander, the facilitator of the support group, says members gave Pathak a lot of feedback.

SHARON ALEXANDER: They all had opinions and he would be scribbling them down. And yeah, this is where we are today. This has been phenomenal for us.

JAFFE: The product just became available commercially last December. And it's not cheap, almost $300. Pathak doesn't disclose exactly how many he's sold. Let's just say more than a thousand. Medicare and private insurance don't pay for the devices yet. But a handful of VA medical centers do. Meanwhile, Pathak has raised enough money on the Internet and through foundations to give away a couple of hundred spoons to people who can't afford them.

And soon there will be new attachments. A fork and a soupspoon should be available next month. On the drawing board are devices for holding a door key steady and grabbing small objects.

PATHAK: We want it to be like a Swiss army knife. So it's not just for a spoon. It's for a whole bunch of other things.

JAFFE: Which could stabilize the lives and maintain the independence of a lot of people with essential tremor and Parkinson's disease.

Ina Jaffe, NPR News. Transcript provided by NPR, Copyright NPR.