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Shake-canceling spoon for people whose tremors make it difficult to eat

Lift Labs, based in San Francisco, developed a special shake-canceling spoon for people who's hands shake with tremors, making it difficult to get food from plate, cup, glass or spoon to mouth. The new device resembles an extra-large electronic toothbrush base. The "Liftware Spoon" can adjust rapidly to the shaking of the user's hand, keeping a detachable spoon or other eating or drinking utensil steady. In other words, it shakes the spoon in exactly the opposite way that the person's hand shakes.

A device developed by Lift Labs, contains microelectronics in the base that allow it to cancel out the effects of hand tremors suffered by essential tremor patients.
Photo credit: Lift Labs. This device, developed by Lift Labs, contains microelectronics in the base that allow it to cancel out the effects of hand tremors suffered by essential tremor patients.

For those interested in building a better device that is eagerly needed in the community when it comes to eating, high up on the list is such a shake-canceling spoon. On numerous occasions we've eaten in Sacramento buffet restaurants with our social group of older adults whose hands shake so rapidly, that the food flies off the dish as they try to manage spooning small amounts buffet items onto their plate. It becomes more complicated once at the table trying to spoon the food from plate to mouth.

For years, these friends had to be assisted in carrying the plate to the table and often when eating. But finally, scientists have designed a stable spoon for shaky hands. The device helps essential tremor patients. Finally, the University of Michigan (U-M) engineering alumni's company developed a shake-canceling device. The concept is called ACT, or active cancellation of tremor.

For people whose hands shake uncontrollably due to a medical condition, just eating can be a frustrating and embarrassing ordeal – enough to keep them from sharing a meal with others. But a small new study conducted at the University of Michigan Health System suggests that a new handheld electronic device can help such patients overcome the hand shakes caused by essential tremor, the most common movement disorder. Imagine how many people it can help who have movement disorders where their hands shake so violently that the food flies off the spoon or fork between the plate or bowl and their mouth.

In a clinical trial involving 15 adults with moderate essential tremor, the device improved patients' ability to hold a spoon still enough to eat with it, and to use it to scoop up mock food and bring it to their mouths

The researchers measured the effect three ways: using a standard tremor rating, the patients' own ratings, and digital readings of the spoon's movement. The results are recently published online in the journal Movement Disorders by a research team that includes University of Michigan neurologist and essential tremor specialist Kelvin Chou, M.D., as well as three people from the small startup company, Lift Labs,, that makes the device, called Liftware. The study was funded by a Small Business Innovation Research grant from the National Institutes of Health that the researchers applied for together. Check out the site, "Liftware by Lift Labs." Or see the YouTube videos, "Liftware Spoon 12-16-13" or "Getting Started with Liftware."

Public-private partnership – with a Michigan difference

The technology came full circle to its test in the University of Michigan (UMHS clinic. The company's CEO, Anupam Pathak, Ph.D., received his doctorate from the University of Michigan (U-M) College of Engineering – where he first worked on tremor-cancelling advanced microelectronic technologies for other purposes.

The concept is called ACT, or active cancellation of tremor. It relies on tiny electronic devices that work together to sense movement in different directions in real time, and then make a quick and precise counter-motion. But to truly test whether their prototype device could help essential tremor patients overcome their condition's effects, the Lift Labs team turned to Chou, who with his colleagues sees hundreds of essential tremor patients a year.

UMHS offers comprehensive care for the condition as part of its Movement Disorders Center

Chou and his colleagues have experience in prescribing a range of medication to calm tremors, and evaluating which patients might benefit from advanced brain surgery to implant a device that can calm the uncontrollable nerve impulses that cause tremor. "Only about 70 percent of patients respond to medication, and only about 10 percent qualify for surgery, which has a high and lasting success rate," says Chou, according to the February 28, 2014 news release, "Shaky hand, stable spoon: U-M study shows device helps essential tremor patients."

Chou is an associate professor in the University of Michigan's Medical School's departments of Neurology and Neurosurgery. "People get really frustrated by tremor, and experience embarrassment that often leads to social isolation because they're always feeling conscious not just eating but even drinking from a cup or glass."

The trial, Chou says, according to the news release, showed that the amplitude of movement due to the tremor decreased measurably, and that patients could move the spoon much more normally. Though the trial did not include patients with hand tremors caused by other movement disorders such as Parkinson's disease, the device may be useful to such patients too, he notes.

"A key aspect of Liftware is a design with empathy. We hear of people struggling every day, and decided to apply technology in a way to directly help. We hope the final product is something people can feel proud of using, and allow them to regain independence and dignity," says Anupam Pathak, Ph.D, the Lift Labs CEO, according to the news release.

How the study was done

The researchers tested the device's impact both with the microelectronics turned on, and with them turned off so there was no correction for movement. Patients and Chou could not tell by feeling the device whether it was on or off.

All three measures – objective rating by Chou, subjective rating by patients, and digital data from the device's connection to a computer – showed improvement for eating and transferring items when the device was turned on, compared to when it was off.

When the patients were asked to simply hold the spoon halfway between the table and their mouth, the two objective measures showed improvement when the device was on, though the patients didn't report a significant difference themselves.

"Our data show this device has very good potential to assist those who have tremor and aren't candidates for surgery," Chou says, according to the news release. "Compared with other devices designed to limit tremor by weighting or constraining limbs, this approach allows movement and is easier to use."

The study included 15 adults between the ages of 59 and 80 whose tremor caused them to spill food or drink. They had experienced tremor for anywhere from 5 years to 57 years. All of the patients stopped taking their medication temporarily before testing the Liftware device. Five of the patients had undergone deep brain stimulation, but turned off their tremor-controlling implant for the study.

Imagine if parts of your body moved when you didn't want them to, and you're trying to eat a nutritious meal

If you have a movement disorder, you experience these kinds of impaired movement. Dyskinesia is abnormal uncontrolled movement and is a common symptom of many movement disorders. Tremors are a type of dyskinesia.

Nerve diseases cause many movement disorders, such as Parkinson's disease. Other causes include injuries, autoimmune diseases, infections and certain medicines. Many movement disorders are inherited, which means they run in families. At last there's a spoon that lets you eat without assistance.

Lift Labs is now developing other attachments for the Liftware device, and working with the International Essential Tremor Foundation to raise money to give devices to people with essential tremor who cannot afford the $295 price of a base unit.

In addition to Chou, who does not have a business relationship with Lift Labs, and Pathak, who co-holds two U-M patents with others who developed the ACT approach, the research team included Lift Labs' John A. Redmond, Ph.D., and Michael Allen. The research was funded by NIH SBIR grant 5R44NS070438. Chou is the Thomas H. and Susan C. Brown Early Career Professor of Neurology. For more information on essential tremor care at UMHS, visit its website, UM Health. More information on the Liftware product, see the Lift Labs Design site.

You also may be interested in taking a look at the PDF format article, "Nutrition After Fifty: Tips and Recipes" from the American Institute for Cancer Research. Or see the report, "Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective," published by the American Institute for Cancer Research.

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