“Our freedom can be measured by the number of things we can walk away from.” Vernon Howard, an American author, philosopher, and spiritual teacher said it rightly. But what about those people who can’t walk away from the toxicicity in their lives? And what about those people who can’t walk without support?

Enabling people to move on their own is crucial to unleashing full human potential. However, 0.1 billion people worldwide need a wheelchair to move around. Paralyzed individuals could walk again by using a robotic Exoskeleton. However, due to their high access price (120k€) and high weight (25 kg), exoskeletons are only found in large hospitals.

Alfons Carnicero, CEO and Co-founder was moved by these people’s pain and made it a clear mission of enabling mobility to everyone by co-founding ABLE Human Motion. “We create lightweight and affordable exoskeleton technology to empower every person in a wheelchair, by providing better mobility and greater independence,” says Alfons.

He further explained the company’s core values that have helped ABLE Human Motion to strongly march to achieving its mission.

• Mobility is a fundamental part of living in society autonomously and freely, engaging in daily activities.
• Innovation: Cutting-edge technology backed by research through the company’s collaboration with the UPC Biomechanical Engineering Lab.
• User-centered: Solutions at the service of people.
• Inclusiveness: Being different by focusing on people and their issues.

Accessibility at its core

Right after its inception, the company took the first step towards its mission by launching ABLE Exoskeleton. According to the company, it is the first lightweight, easy-to-use, and affordable robotic exoskeleton that allows paraplegic individuals to stand up and walk again on their own. The system incorporates the most advanced robotics and Motion control techniques, together with Machine Learning algorithms to optimize the gait patterns.

There are similar competitive devices in the market that focus on targeting all lower-limb mobility impairments with a single device (one-size-fits-all approach). This results in very expensive (from €60k to €150k), heavy (from 14 to 25kg), and complex devices that can only be afforded by large clinical institutions.

Explaining how ABLE Human Motion gained an edge over the established brands in this niche, Alfons says, “At ABLE, we are trying to disrupt the exoskeleton market from the bottom up, focusing on the design of exoskeletons for specific pathologies, resulting in user-centered solutions with lightness, adaptation to their motor capabilities, continuum of care from the hospital to home, and cost-effectiveness.”

This approach, together with years of research at UPC and key partnerships, has led to the ABLE Exoskeleton: the first lightweight, intuitive, and affordable robotic exoskeleton that allows paraplegic individuals to stand up and walk autonomously.

Alfons believes that the compact and lightweight design of the company’s exoskeleton, along with the significant cost reduction, will drive a much faster penetration in the domestic market.

A visionary

As a healthcare entrepreneur Alfons has participated in several acceleration programs including CRAASH Barcelona, Toyota Startup Accelerator, and CaixaImpulse. He also completed various business and management courses at renowned universities such as Cambridge Judge Business School, EADA, and ISDI.

He holds a Master’s in Industrial and Biomedical Engineering from the Universitat Politècnica de Catalunya (UPC) and has proven skills in fundraising, leadership, and Medtech go-to-market.

His work in the areas of product development, clinical evaluation, and manufacturing at Implantcast (German medical device manufacturer of joint implants) and Institut Guttmann (neurorehabilitation hospital) helped him hone his skills and gain crucial experience in the Medtech market.

Taking further this rich experience and expertise, in October 2018, Alfons co-founded ABLE Human Motion, a Barcelona-based start-up developing medical robotic exoskeletons. Within a couple of years, ABLE Human Motion has secured 2.3 M€ from private investors and public funds, growing the team from 3 to 12 people.

The team has successfully developed the first affordable, lightweight, and intuitive exoskeleton for paraplegic individuals, which is currently under clinical trials in Germany and Spain. The company is positioned among the most promising medical device start-ups in Europe, winning the Best European Robotics Startup in 2020 and the Toyota Startup Awards ‘Mobility for All’ competition.

An innovative step towards future

New technologies have transformed our society and our lives and have a massive impact and the adaptation rate in the healthcare industry. The unprecedented speed at which the COVID-19 vaccine has been developed was possible due to the years of previous research, worldwide collaboration, faster manufacturing methods, and enormous investments.

As for the current healthcare innovation, many of these are digitally enabled and driven by advancements in robotics, artificial intelligence (AI), new manufacturing methods, data analytics, and virtual reality.

Robotics and especially exoskeleton technology is set to bring a tremendous impact on global health, by increasing the mobility and independence of neurologic patients and the elderly population while reducing the likelihood of accidents and falls.

However, not all it’s good news here, as the pandemic has caused millions of deaths around the world and triggered one of the largest economic crisis exposing the vulnerabilities of current healthcare systems and supply chains and the worst inequalities between continents and countries. “Now, while we recover from this crisis,” says Alfons, “As a society, we should prioritize health and research to promote well-being and prosperity in the years to come.”

The flexibility of work during the lockdown

COVID-19 has impacted the whole world in more ways than one. While the healthcare industry has been struggling to operate on limited resources the pandemic also impacted the activities within the supporting niches in the healthcare industry. Alfons shared how the company managed its operations during the series of lockdowns.

“ABLE project was affected to some extent, but we have managed to minimize its impact to avoid deviations from the initial planning,” he said.

He further added, “Some of the challenges we had to face were that some suppliers closed during the quarantine, which delayed the manufacturing of some parts. This forced us to strengthen our internal operations and our relations with suppliers.” Other affectations of the pandemic were that several test patients were cancelled and that patient recruitment in the clinical trials in Germany and Spain was slower than expected.

During the lockdown, the entire staff of ABLE Human Motion was teleworking, which was a challenge for a hardware company with equipment needs. To deal with this challenge the company distributed exoskeleton parts among the team members and set up small domestic workshops.

Later the company adopted the flexible working methodology, where everyday employees could decide if they want to return to the office or continue working from home. Alfons further added the company’s new way of managing operations during the pandemic. “We hold meetings combining virtual and physical attendance, we have promoted the use of software project management tools and we maintain frequent communication,” he says.

Alfons also shared how the team’s efficiency in these exceptional times, without the need of taking any drastic measures such as ERTEs or staff reductions has led the ABLE Human Motion to grow further with 30% growth in the team size.

A commercialized approach

Post the pandemic now that the global economy has started reviving from the COVID crisis, 2021 seems to be the crucial year. During this year ABLE project will be finalizing the clinical trials carrying out in leading neurorehabilitation hospitals in Germany (Heidelberg University Hospital) and Spain (Institut Guttmann and Asepeyo Barcelona) with 40 spinal cord injured patients, to demonstrate the safety and usability of the exoskeleton in a clinical environment.

With this clinical data, the company aims to slightly modify the design to improve the exoskeleton based on the clinical feedback, to later start the CE certification process. Post this, ABLE Human Motion will ambitiously move towards its mission of enabling mobility by starting product commercialization in Europe at the end of 2022.

Alfons further talked about the company’s goals. “We also have other products in our pipeline, as a disruptive and ultra-light exoskeleton for hemiplegic gait after stroke: a powered ankle joint that assists with adaptive algorithms that collaborate with the remaining muscular function and promote the process of neuroplasticity during rehabilitation.”

With stroke being the first cause of movement disability in the US and Europe (1 in 6 people will have a stroke in their lifetime), Alfons believes that this device will be a game-changer, situated in a unique position to set a new standard for the post-stroke rehabilitation. ABLE Human Motion is working on the said device to enter the European market in 2024, after obtaining the CE-mark approval.

While sharing the company’s diligent goals Alfons also expressed gratitude towards the team’s efforts and collaborations with expert advisors. “We are scaling our company by understanding very well our needs at each phase and maximizing the resources available,” he says,

He further adds, “The help of world-class advisors that have been serial entrepreneurs and have many years of experience commercializing healthcare products has been critical. Working with industry leaders like Institut Guttmann or Heidelberg University Hospital and having the support of best-in-class organizations like EIT Health (European Institute of Innovation & Technology), the European Commission, Bank Sabadell or La Caixa Foundation is also a key driver to move forward.”

Accounting Brilliance

“ABLE Human Motion is a great example of leveraging technology in an innovative way to solve an important unmet need that will make a significant difference in people’s lives today! They restore the power of walking for those suffering from spinal cord injury, creating a significant lifestyle and health benefits. I had the opportunity to work closely with the dynamic team driving this company forward as part of the 2019 CRAASH Barcelona program – an intense 12-week program for teams to engage stakeholders to develop and validate a value proposition and go-to-market plan with industry veterans. The team made the most of this and every opportunity they have made happen and have been on an accelerated trajectory to reaching the market ever since! ABLE team’s addresses a very important unmet need, having validated their users, economic buyers, value proposition and business model.” – John Collins, Ph.D., COO at Consortia for Improving Medicine with Innovation & Technology (CIMIT, Boston).

“I commend the team at Able on focusing their work on developing a low-cost exoskeleton system. I believe that several individuals with mobility-limiting conditions – such as spinal cord injury – would tremendously benefit from a low-cost exoskeleton system of the type developed by ABLE. Developing low-cost exoskeleton technology without sacrificing quality is a challenge that the engineers at ABLE appear to have handled excellently.”

– Paolo Bonato, Ph.D., Dir. of the Motion Analysis Lab. at Spaulding Rehab. Hospital (Boston, USA) and Prof. at Harvard Medical School and Wyss Institute.

“I have tried 3 exoskeletons and only with ABLE I feel like being in control of my walking again.” – Ivan Camps, individual with spinal cord injury.

“ABLE plays by the typical disruption playbook: entering the market with a radically lower cost solution by reducing features, focusing on a smaller, yet still sizeable niche market, with a different business model and with possibilities to extend from there to become a dominant player in the global arena in medical exoskeletons. ABLE enters the market with a lower-cost solution, with possibilities to become a dominant player in the global industry of exoskeletons.”

– Bart Huisken, MBA, Serial Entrepreneur

“ABLE is one of the top health tech projects in Barcelona. A young but high-performance team with enthusiasm to develop a new approach to exoskeletons. They will be really good to deliver new technologies to solve a serious health problem.”

– Pau Corbera, President at Advero Properties Socimi

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