Startup Constant Therapy applies Big Data to brain rehab

Don’t call Constant Therapy a brain game. This app uses Big Data to help survivors of strokes and traumatic brain injuries regain lost cognitive and language skills.

It also lets speech-language pathologists and occupational therapists plan homework and track their patients’ at-home adherence and overall progress. When the number of therapy visits allowed by insurance is over, patients may subscribe to the service to continue working independently.

The startup, launched by Boston University, has 65 task categories and more than 60,000 exercises and is available for use on an iPad, Android or Kindle tablet.

Big Data allows the app to move the patient to more difficult tasks or substitute an exercise if the patient is having difficulty. Patients appreciate that they and their therapists can track their progress, according to CEO Keith Cooper. They also appreciate not having to repeat the same exercise until they get it right, unlike some brain games.

“We make sure we’re not testing, testing, testing,” Cooper said. “The brain games are very very stressful and not very helpful for people who have had these injuries. We now very predictably know the goals the people can get to.”

Rhozine Perez, an SLP at Houston Methodist outpatient rehabilitation in Texas, has been using Constant Therapy for about a year with her patients, most of whom have had strokes. She has tried other apps, including a heavily advertised brain game that did not allow her to track her patients’ progress or control what they were working on. That app left patients discouraged about what they couldn’t do, according to Perez.

“They really want to have that positive feedback,” she said.

Constant Therapy has some heavy hitters behind it. Swathi Kiran, director of the aphasia research laboratory at Boston University, came up with the idea of digitizing therapy solutions for traumatic brain injury patients and making them mobile, according to Cooper.

Kiran co-founded Constant Therapy with company President Veera Anantha, who spent seven years at Motorola Solutions, first as director of operations and engineering, and then as director of enterprise networking and communication. Kiran remains a scientific advisor to the company.

Cooper said he fell in love with the idea and joined the team just over a year ago. A startup and turnaround specialist for IT companies, Cooper led Rutgers University tech spinoff company Connotate, which provides web extraction and monitoring services for Internet service providers and corporate clients. Cooper was also president of data backup service Carbonite. His current task is to commercialize Constant Therapy.

The company collects data points for every touch of the screen and every word uttered by a patient while using the app. It recently analyzed 22 million exercises that patients worked on, searching for clues they requested, and the order and timing of those requests, among other information. The study showed that those who use the app at ­home practice more and show greater improvements in both cognitive and speech accuracy and in processing speed.

Among the study’s findings:

• Accuracy in language and cognitive exercises improved 15 percent in individuals with severe impairments by completing 100 exercises, and 40 percent for those completing 500 or more of the same exercises.
• Processing speed in language and cognitive exercises improved more than 20 percent with 100 items completed, and over 80 percent after completing more than 500 exercises.
• Stroke survivors engaged in at­-home therapy receive 5 times more therapy than patients receiving in­-clinic therapy alone.

Constant Therapy uses all the data it collects from patients to personalize therapy and optimize outcomes based on what worked for patients with similar demographics and diagnoses, Cooper said. Patients with the most severe deficits can improve very quickly, almost to the levels of others who started therapy with less severe impairments, Cooper said.

Perez had one of those patients. The man, in his 50s, had such severe deficits that his wife could not care for him at home. He made very little progress during a year of traditional inpatient and outpatient speech-language therapy.

Perez suggested that he try Constant Therapy. The man couldn’t even start the program at first, but now can use it on his own for up to an hour a day, Perez said. His progress gives the man hope that he can return home.

“These people should never be written off as being so severe that they can’t improve,” Cooper said.

Other patients appreciate that Perez can explain why they found some tasks difficult, she added.

Constant Therapy gives the app to SLPs and OTs to use with their patients, according to Cooper. Individuals may purchase subscriptions for $20 per month or $200 per year after they complete therapy.

About 80 percent of its users find the app through their therapists, while the rest discover it on their own, he noted. The company hasn’t done much advertising, relying so far on word-of-mouth.

Its potential market is vast. About 1.7 million people in the United States suffer a traumatic brain injury every year, and another 800,000 have a stroke, according to the Centers for Disease Control and Prevention.

The company is using the $2 million it recently raised from investors to work with regulatory and reimbursement consultants on commercializing the app.

“We are hopeful that we can have some significant progress over the next three months,” Cooper said.

Constant Therapy plans to have an independent source verify its internal study, he added. It also discovered “very interesting improvements and trends” among patients who self-identified as having early-stage Alzheimer’s disease, Cooper said. That led Kiran and BU neurology professor Dr. Andrew Budson to launch a study of the effects of using Constant Therapy with 50 patients — all with early-stage Alzheimer’s disease or its precursor, mild cognitive impairment — from Budson’s clinic, Boston Center for Memory.

“One advantage of iPad-based therapy is they can do it wherever they wish,” Budson said. “They’re doing it at home. The study coordinator goes out to their home to get it set up and there are weekly check-in phone calls.”

The goal is to see whether the types of exercises included in Constant Therapy can help people with early-stage Alzheimer’s maintain their clarity for a longer period of time, according to Cooper.

Cooper described Constant Therapy as a “double-bottom-line” business that wants to get the app into the hands of everyone who might benefit from it. The company provides an Android tablet for users who subscribe for a year and offers scholarships to those who cannot afford a subscription.

“We do not decline anybody use of the product based on financial issues,” he said.

Image: Constant Therapy