By Hannah Weems

The UAB Department of Biomedical Engineering (BME) is known for routinely tackling daunting health problems head-on and has been doing so for more than forty years. In the community of people living with mobility impairments, affordability is one of the largest issues facing accessibility to therapeutic devices. It is no surprise, then, that UAB graduate students decided to directly combat this problem with the creation and development of a device called the “Motogaitor.”

This device is a motorized elliptical machine that was originally created and tested by Andres Guerrero in 2018 and has more recently been developed by graduate students in Biomedical Engineering, Ezz Abuhussein and John Easton, to treat a larger variety of patients on a budget and from home.

guerrero2021Andres Guerrero, travelled to the United States after having completed his Bachelor of Science in Mechatronics Engineering at the Escuela Politecnica del Ejercito in Ecuador. In 2016, he enrolled in the University of Alabama at Birmingham’s Master of Design and Commercialization program.  

“I was interested in using my engineering knowledge to help solve real world problems. When I heard about this program, I knew it was what I had been looking for,” says Guerrero.

It was at UAB that Guerrero was able to expand his design skills and expertise in the area of robotics. His goal was to develop products that would be used in the physical rehabilitation of children to improve mobility. Guerrero worked alongside Alan Eberhardt, Ph.D., Professor and Associate Chair of Education in the BME department at UAB. Dr. Eberhardt’s courses provided Guerrero with countless opportunities to find solutions to problems, but none were potentially as notable as the need of a local Children’s of Alabama patient, a 2-year-old child diagnosed with Level IV cerebral palsy. This illness increases spasticity in the limbs and impairs walking. The child’s mother reached out to Dr. Eberhardt in hopes of finding a device to help her child receive the rehabilitation he needed from home.

Guerrero observed the child’s condition, therapy and weekly routines before deciding to create an assistive device that could prevent the stress of constant travel to various therapy appointments. He worked in collaboration with Dr. Eberhardt and Steve Thompson, Director of the UAB Design and Fabrication Center, to develop the Motogaitor. Its design allows for a child to fit in the harness and stand on the pedals which gently move their muscles, on both upper and lower limbs, to help develop flexibility and strength.

motogaitor1(left) User testing at Lakeshore (Ezz standing), (center) User testing at United Ability; (right) new additions to Motogaitor including freewheeling sprocket, adjustable resistance belt, and differential stride positioning

The team purchased a commercial elliptical device to provide the Motogaitor’s frame and elliptical function. An adjustable harness was created along with a portable frame structure which provided body weight support for the user to ambulate in place with the assistance of motorized pedals programmed to move continuously or in a prescribed stepping pattern. A stepper motor was joined to the main wheel using a chain-sprocket mechanism and the wheel was modified to allow for varying stride lengths. Velcro foot inserts were included on the pedals which would ensure its user remained attached to the elliptical and a holding tray was included to hold entertainment devices for the user. User testing of the Motogaitor was completed in 2018 at Lakeshore Foundation and United Ability in Birmingham, AL on nine children with differing mobility impairments, under parent and therapist supervision. Improvements were made to the device after testing, such as the implementation of a gait trainer to more easily position children over the elliptical.

motogaitor inlineJohn Easton pictured with Motogaitor EliteIn 2020, John Easton, a BME graduate student and Experimental Biomechanics Core Lab Coordinator, decided to take the novel Motogaitor invention a step further for his master’s thesis in BME by broadening its use for post-stroke adult users. He began working on the second machine, dubbing the newly designed variation the “Motogaitor Elite.”

The Motogaitor Elite is a specialized elliptical designed for users with hemiplegia due to stroke. It features walker accessibility, adjustable unilateral and bilateral resistance and freewheeling motor assistance. A difference in mechanical advantage between the left and right legs was achieved by adjustment of the pin and slider along the crank arm which allowed for the user to pedal against resistance.

By design, the Motogaitor Elite is relatively low cost, in hopes of increasing the likelihood of owning a therapy device such as this one in the home. Easton says, “We need more affordable devices that address the needs of this population. They are lacking in the market at present.”

motogaitor23-D rendering of completed Motogaitor Elite“This equipment is significant because it will allow people with disabilities to exercise at home with the potential of improving their gait,” says project mentor Dr. Alan Eberhardt, “We are writing grant proposals to receive funding to do safety and efficacy testing in hopes that the devices can ultimately be commercialized.” The team has a provisional patent on the mechanisms that allow free-wheeling and differential stride length and hope to move forward with commercialization of this cost-efficient device.

The Motogaitor’s original creator, Andres Guerrero, went on to secure his dream position as a Rehabilitation Engineer at Blythedale Children’s Hospital in Valhalla, New York where he develops parts and specialized toys for pediatric therapy. Ezz Abuhussein is now pursuing a Ph.D. at the University of Memphis. The Motogaitor Elite’s creator, John Easton, will graduate from UAB with his Master of Science in Biomedical Engineering in April 2021. He hopes to pursue a job in engineering assistive technology. As for the Motogaitor Elite, the device will act as a prototype for future research which will explore the effect of differential resistance ellipticals on lower limb musculature of users with hemiparesis.

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BioHorizons is a Birmingham company whose history is rooted in UAB. Today, thanks to a growing and successful co-op program, it appears that BioHorizons and UAB will continue to be linked far into the future.

The dental-implant company, which started as a spinoff of research from the UAB Schools of Engineering and Dentistry, has hired more than a dozen UAB alumni and students over the past 28 years. More recently, though, its co-op program has begun to bring in current engineering undergraduates—creating a talent pipeline for students to get a head start in a growing industry.

“Hands-on experience has always been a key element of engineering education,” said Neil Adams, director of the Engineering Career Center. “The success of our program depends on strong co-op and intern partners, like BioHorizons, who offer quality experiences to our students so that they apply their engineering knowledge while also learning how to be a contributing part of a professional organization. We are proud of this continued partnership and look forward to supporting Blazer engineering co-ops at BioHorizons for many years to come.”

A Blazer Legacy

BioHorizons was started in 1995 by the late Martha Bidez, Ph.D., then a faculty member in the School of Engineering who would serve as the company’s first CEO before selling the company and returning to UAB in 2009. Over the years, the company has hired a number of UAB alumni, including several members of its leadership team (see sidebar).

In 2016, however, the company’s ties to UAB got a little closer when Ashley Boggs became the first UAB undergraduate to join the BioHorizons co-op program—a program that provides students the opportunity to work full-time at the company for three semesters, alternating with school. The experience is paid, and students work alongside engineers throughout their time at the company.

Boggs extended her co-op by working part-time at the company until she was hired full time after she graduated in 2018. Today, she is a Digital Dentistry Engineering Manager, and she credits her co-op experience for opening her eyes to possibilities she had never previously considered.

“I had a vague idea that I wanted to work with implants—like hips, knees, ankles—but I didn’t know anything about the dental-implant industry at all,” said Boggs. “During my sophomore year, I went to the Engineering Career Center and told them that I couldn’t keep sitting in class doing problems from a book. They told me about a local company called BioHorizons that was doing on-campus interviews.”

The interview changed Boggs’s personal career trajectory, but her story is not an unusual one. While the engineering curriculum prepares students for a wide variety of careers, it’s often that first on-the-job experience that opens eyes and doors to career opportunities in fields students may have never been aware of.

That was the case for UAB graduate Jonathan Gordon, another former co-op participant who now works as a packaging engineer for BioHorizons. “I started out on a pre-med track, but coming from a very small town to UAB was a big transition,” Gordon said. “I dropped the pre-med route pretty quickly and started looking for other options.”

Like Boggs, the Engineering Career Center helped connect Gordon with a co-op position at BioHorizons, and that, in turn, led to full-time employment. “I realized pretty quickly that I love this industry. It’s exciting to be a part of this.”

An Undergraduate Pipeline

Although Boggs was the first UAB student hired into BioHorizons' co-op program, she soon had company. Three other Blazers followed her into the program (Josh Moore, Karly Casey and Gordon), and all four stayed on to work full-time. That kind of retention is notable for an undergraduate experience that by its nature is often exploratory. 

“Since we started the co-op program about 10 years ago, we have had about 17-18 engineering students in our program—two of which have been in our regulatory department and the rest in research and development,” said Tom Lewis, BioHorizons manager of product engineering. “We feel that it has been very successful, and to date we have hired five as full-time employees.”

That transition from co-op to full-time employee makes sense when you consider the investment BioHorizons makes in students over a three-semester co-op. Each student must learn Quality System processes before getting down to work with tasks, such as design control, drawing release, and CAD modeling. “Each student is trained, but it takes hands-on involvement to learn all of these processes,” Lewis said. “It’s also helpful for students to experience how different departments work together for a common goal.”

In addition, students must learn industry standards and technologies in the medical device industry. “This takes longer,” Lewis said, “but over time they begin to understand the ‘whys’ behind the design of dental implants, restorative components and instruments. Although we have the expectation that co-ops produce for us, my hope is that when they look back they realize the value of their experience here, and as they move into their careers they have a head start in their understanding of engineering organizations."

“Co-op is both an investment by the company and a commitment by the student,” added Adams. “The depth of experience pays dividends in that co-op students are ready to contribute immediately at an organization after graduation.”

 

“I have been part of teams in which we have drawn and developed state of the art dental surgery kits that are slated to hit the market this year; I have managed drafting and conducting test plans to research the durability of implant designs; and, most importantly, I have been able to teach incoming co-ops the ins and outs of the company and guide them as they grow from a college student into true engineers.”
—Benjamin Pody, mechanical engineering student and 2nd-year co-op

 

Homegrown Talent

Lewis says the co-op program historically has drawn from several area universities, but he admits UAB students have one obvious advantage. “Since they are local, they already have living arrangements,” he said. “After completing the three co-op terms, students return to school to finish up and graduate.  With UAB being in town, when the opportunity was available several UAB students have stayed on and worked part-time until graduation.  The company knowledge they have has allowed them to be productive even on a part-time basis.”

While the growth of BioHorizons’ co-op program is exciting for current and future engineering students, UAB School of Engineering Dean Jeff Holmes, M.D., Ph.D., says that is just one of the reasons UAB engineers should look at the BioHorizons story with pride.

“It’s not unusual for a promising startup to spin off from university research—in this case, arising from research in the UAB Schools of Engineering and Dentistry,” said Holmes. “We often comment that these startups have the potential to revolutionize an industry. But in the case of BioHorizons, it has actually done that, and it continues to innovate and to grow. I am tremendously excited that our students are able to be a part of that continuing UAB success story.”

“At BioHorizons, we look forward to continuing our work with UAB in the future,” agreed Lewis. “We appreciate the relationship we have developed with the university that has served us well over the years.”

 

BioHorizons Senior Leadership

A glance at the BioHorizons team shows a number of UAB graduates among the senior leadership.

R. Steve Boggan, President and CEO

  •   M.S. in Biomedical Engineering from UAB

J. Todd Strong, Executive VP and COO

  •   M.S. in Biomedical Engineering from UAB

Mike Mills, Executive VP and CFO

  •   B.S. from UAB Collat School of Business

Andrew Baroody, VP of Sales Operations

  •   B.A. in English from UAB

Juan Jaramillo, VP of Global Business Support

  •   UAB Graduate

Fred J. Molz, IV, VP of Research and Development

  •   M.S. and Ph.D. in Biomedical Engineering from UAB

Elbert Jenkins II, VP of Information Technology

  •   MEng in Information Engineering Management from UAB
  •   MBA from the UAB Collat School of Business

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