Myomo's MyoPro Gains Market Favor with $13.9M IPO and 15% Product Revenue Growth

Stroke, a "four-highs" disease characterized by high prevalence, high incidence, high mortality, and high disability rates, is one of the leading causes of disability and hemiplegia.

According to the Global Burden of Disease (GBD) data, in 2019, there were an estimated 12.2 million incident cases of stroke and 101 million prevalent cases worldwide; this resulted in 143 million disability-adjusted life years (DALYs) and 6.55 million deaths. Stroke has become the third leading cause of death and disability (DALYs) globally, accounting for 5.7% of total global DALYs.

Neuromuscular disorders and brain injuries, such as stroke, multiple sclerosis, brachial plexus injury, spinal cord injury, traumatic brain injury, neuromuscular injury, and muscle weakness, are the primary causes of hemiparesis or hemiplegia in patients. Arm paralysis, difficulty walking, hemiplegia, and an inability to perform activities of daily living independently are common challenges faced by these patients. Restoring limb motor function is the primary goal for most patients.

Myomo is an innovative medical device company dedicated to improving the lives of patients with upper-limb paralysis by providing medical devices. Founded in 2004, Myomo is currently headquartered in Massachusetts, USA. Its Chief Commercial Officer is Micah Mitchell, who has over 20 years of experience in providing high-end medical devices to people with disabilities to help improve their quality of life.

Leveraging proprietary technologies developed by the Massachusetts Institute of Technology, Harvard Medical School, and the company, Myomo has created MyoPro. MyoPro is a non-invasive upper-limb rehabilitation orthosis designed to help patients with upper-limb paralysis resulting from stroke, brachial plexus injury, traumatic brain injury, spinal cord injury, amyotrophic lateral sclerosis (ALS), or other neuromuscular disorders or injuries regain motor function in their hands and arms, offering a novel approach to arm rehabilitation for individuals with upper-limb paralysis.

According to data from *Nursing Coordination in Stroke Rehabilitation Therapy*, rehabilitation therapy enables 90% of stroke patients to regain walking ability and activities of daily living, and allows 30% of patients to return to light-duty work; without rehabilitation therapy, only 6% regain walking ability and activities of daily living, and 5% return to light-duty work.

Currently, exoskeleton robot technology is a primary technology in the field of rehabilitation medicine. This technology combines artificial intelligence with mechanical power devices to provide patients with additional power, thereby enhancing human body functions and assisting patients in undergoing rehabilitation training.

However, current functional rehabilitation robots still face several challenges, such as an overemphasis on passive training, weak human-robot interaction capabilities, and a lack of personalized training protocols. Furthermore, ergonomic design, ease of operation, reliability, and safety tolerance require improvement. These limitations often result in suboptimal rehabilitation outcomes for patients, potentially causing them to miss the critical window for optimal recovery.

MyoPro is a wearable upper-limb rehabilitation orthosis that integrates technologies from robotics and neuroscience, incorporating non-invasive sensors, motors, and control systems within the device. The orthosis features a control panel and a lightweight battery on its side.

When patients wear the MyoPro on their paralyzed arm and press the command on the control panel to activate the system, sensors read and amplify the weak electromyographic (EMG) signals from the skin surface to activate the motors, helping patients perform hand movements such as opening and closing fingers, bending, lifting, and extending the elbow.

The MyoPro orthosis is constructed from lightweight metal alloys and weighs approximately 1.5–2 kg. Additionally, its contour-conforming design, which closely matches the patient’s arm anatomy, facilitates a range of motion from 0 to 130 degrees. The motors at the elbow and hand deliver 7 Nm of torque at the elbow joint and 1–2.7 Nm of finger torque, respectively, enabling patients to lift weights of approximately 2.5–3.6 kg. Featuring a rechargeable, replaceable battery design, the device allows for extended daily wear, helping patients regain independence in activities of daily living—such as self-feeding, carrying objects, and performing household chores—and even return to work.

Since its inception, Myomo has continuously innovated, developing sensor technology capable of extracting more information from EMG signals. Following the launch of MyoPro, the company subsequently introduced MyoPro2 and MyoPro2+, providing patients with more sensitive and lightweight upper-limb rehabilitation products.

The MyoPro product series received FDA 510(k) clearance in 2007 and CE marking approval in 2017. Furthermore, MyoPro is currently the only exoskeleton robotic rehabilitation device covered by U.S. Medicare in the United States. It has also been approved by Australia’s National Disability Insurance Scheme (NDIS), which will provide reimbursement services to approximately 500,000 Australians with disabilities, helping them access MyoPro at a lower cost.

There is a good reason why MyoPro has gained particular favor in the market compared to traditional rehabilitation robots.

On the one hand, to achieve optimal performance and effective rehabilitation outcomes with MyoPro, Myomo has developed a comprehensive, personalized rehabilitation treatment plan for patients.

First, customize the MyoPro orthosis. Prior to purchase, physicians conduct screening assessments to ensure patients are suitable candidates for MyoPro-assisted rehabilitation therapy. Subsequently, a Certified Prosthetist and Orthotist (CPO) creates a 1:1 mold based on the patient’s arm shape and size. During the fabrication of the final device, the CPO adjusts and calibrates the software settings within the system to ensure that sensors properly detect and amplify the patient’s electromyographic (EMG) signals, ultimately producing a MyoPro upper-limb rehabilitation orthosis tailored exclusively to that patient.

Second, customize the rehabilitation treatment plan. After patients wear MyoPro, specialized doctors will customize a rehabilitation treatment plan for them based on their condition and needs. In the initial period of wearing MyoPro, patients need to participate in training conducted by doctors on how to use the device, such as practicing putting on and taking off MyoPro, setting different training modes, and other exercises to familiarize themselves with operating MyoPro. Doctors will continuously adjust the rehabilitation treatment plan according to the patient's training progress to ensure that the patient adapts to the rehabilitation training to the greatest extent possible. Finally, patients can take MyoPro home and carry out rehabilitation treatment training independently.

In addition, Myomo offers the MyoCare program and MyoCoach clinical resources. These services not only arrange follow-up rehabilitative care with therapists for patients but also provide remote guidance from professional rehabilitation coaches. This approach encourages patients to actively engage in their rehabilitation plans, helping them better utilize the MyoPro orthosis to improve mobility in their paralyzed arms.

On the other hand, the design of the four non-invasive EMG signal sensors on the MyoPro device enhances its safety and interactivity. Unlike implanted sensors, MyoPro’s sensors are mounted on the brace and correspond to four specific muscle groups: the biceps, triceps, finger flexors, and finger extensors.

When the patient intends to move their arm, the sensor reads the electromyography (EMG) signals generated on the surface of the skin. When the EMG signals exceed the threshold level set by the physician, the sensor amplifies and transmits them to two small Maxon motors located at the elbow and hand. This activates the control system within the orthosis, which drives the device to provide powered assistance to the patient’s hand, enabling the patient to independently complete hand movements.

Svetlana Pundik, M.D., and colleagues conducted a study on the therapeutic efficacy of electromyographic (EMG) arm orthoses, analyzing 13 patients who underwent rehabilitation using the MyoPro. The results demonstrated significant improvement in arm motor function following the use of the MyoPro. Product satisfaction surveys among the 13 participants further indicated that they were satisfied with the MyoPro throughout their involvement in the study.

Motor recovery after stroke or traumatic brain injury is based on brain plasticity. Motor learning-based therapy, which utilizes high-repetition, task-oriented exercises initiated in a timely manner, is one of the effective methods for restoring patients' sensory, motor, and behavioral capabilities. However, traditional rehabilitation programs often require patients to undergo one-on-one training with rehabilitation therapists at hospitals. The fixed location and the lengthy, repetitive nature of the rehabilitation process increase the difficulty and cost of recovery for patients.

Myomo effectively addresses the aforementioned challenges. The MyoPro device is patient-controlled, triggering a series of hand movements only when the patient generates motor intent and corresponding electromyography (EMG) signals. Furthermore, its high adjustability and portability enable patients to gradually tailor their rehabilitation plans to their individual conditions and independently determine the timing and location of their practice sessions.

The “autonomous” feature of MyoPro stimulates patients’ awareness of repetitive exercise. By compensating for physical impairments, MyoPro enables patients to perform hand movements they previously “wanted to do but could not.” When the paralyzed arm executes its first movement with the device’s assistance, it motivates patients to attempt additional movements. This process allows patients to derive satisfaction and a sense of achievement from incremental successes, ultimately encouraging them to complete the entire complex and challenging rehabilitation program.

On the other hand, Myomo has launched a video game called MyoGames. MyoGames is a rehabilitation-oriented “basketball” game specifically designed for MyoPro users, training patients’ upper-limb motor skills through simple actions such as catching, throwing, and gripping the ball. It is delivered to patients as part of the MyoPro service package, initially available free of charge; after the free trial period expires, patients are required to subscribe on a monthly basis. The game can be installed on the laptop provided by Myomo, or it can be installed on other computers compatible with Windows 7 and later operating systems.

MyoPro features four independent modes: biceps mode, triceps mode, hand-closing mode, and hand-opening mode. These four modes can be switched freely and combined in any configuration. Before starting the game, the patient sets MyoPro from standby mode to an appropriate exercise mode, such as biceps or triceps mode, and connects MyoPro to the computer via Bluetooth, thereby establishing an interactive interface with MyoGames.

At the start of the game, a basketball appears on the screen. The patient moves their arm according to on-screen instructions to perform corresponding actions, such as catching or shooting the basketball. Each game session lasts 60 seconds, during which the system records the duration and repetition count for each new movement performed by the patient. Based on the outcomes of each session, the patient and therapist establish specific gaming goals and guide subsequent rehabilitation training to align with the patient’s upper limb recovery process.

As an adjunctive therapy to MyoPro, MyoGames makes repetitive rehabilitation exercises engaging, thereby enhancing therapeutic outcomes and improving patients’ ability to perform activities of daily living (ADLs), which accelerates the recovery process.

In 2017, Myomo successfully completed its initial public offering (IPO). On August 25, Myomo priced its public offering of 7,333,334 shares of common stock (or common stock equivalents) at $0.60 per share, raising approximately $4.4 million in gross proceeds. Myomo plans to use the net proceeds for general corporate purposes, which may include working capital and capital expenditures, research and development expenses, and sales and marketing activities. Following the IPO, Myomo raised a total of $13.9 million. After eight prior rounds of financing, Myomo’s cumulative funding reached $27.6 million.

According to the financial report released by Myomo, Myomo’s revenue in the second quarter of 2023 was $6 million, representing a 15% year-over-year increase in product revenue compared to the second quarter of 2022. As of June 30, the company had served nearly 1,000 patients, marking a 27% growth in patient volume.

Myomo Chairman and CEO Paul R. Gudonis stated that, as a next step, Myomo will strengthen its collaboration with Chinese medical device companies to expand the sales scope of MyoPro in the Chinese market.

Currently, the rehabilitation robotics market demonstrates significant growth potential. According to Fortune Business Insights, the global rehabilitation robotics market is projected to register a compound annual growth rate (CAGR) of 43.6% from 2022 to 2029. A report by Frost & Sullivan indicates that China’s rehabilitation robotics market reached RMB 210 million in 2018 and is expected to grow at a CAGR of 57.5% in the coming years, reaching approximately RMB 7.95 billion by 2026.

China is becoming the largest market for MyoPro. Taking stroke as an example, the "2020 China Stroke Center Report" shows that China is facing the world's largest stroke challenge. According to GBD data, in 2019, there were 3.94 million new stroke cases in China, with 28.76 million stroke patients and 2.19 million stroke-related deaths. The DALYs caused by stroke reached 45.9 million in 2019, placing a heavy burden on families and society due to rehabilitation treatment. Patients with upper limb paralysis caused by illness urgently need more effective rehabilitation methods.

Currently, Myomo has formally signed a joint venture agreement with Reid Medical and Jiangxi Miaomo Medical Assistive Devices Co., Ltd. The parties will establish a joint venture in China to manufacture and sell the full range of Myomo’s MyoPro products, as well as future offerings, within the Chinese market. Furthermore, the joint venture will set up an R&D team to develop newly upgraded products better suited to the domestic market.

Reference Article:

[1]. Hu S, Wu G, Wu B, et al Rehabilitative training paired with peripheral stimulation promotes motor recovery after ischemic cerebral stroke. Experimental Neurology. 2022;349:113960. doi: 10.1016/j.expneurol.2021.113960.