The Evolution of Myoguide

Myoguide prototypes

The Myoguide you see today started development over 5 years ago. We were initially contacted by some movement disorder clinicians who wanted a portable device to help them carry out their therapeutic injections. The evolution timeline was about a year: Our first rendition was a wireless module that proved inconvenient due to the need for a laptop. The technology worked well, but it was so inconvenient, we needed another approach. We had a brief visit with lean, where we created an EMG only device that was small and ran on two AA batteries (BTX Buddy). This device worked well, but the lack of a stimulator required clinicians to also have a stimulator to cover all guidance procedures. The next version incorporated a stimulator, and a rudimentary LED display. The device could switch modes between EMG and stimulation, and the display would indicate levels during adjustment, and an arbitrary EMG level during the EMG monitoring. The audio section was improved. We chose to use two smaller high fidelity speakers to keep the depth of the device “thin”. However, the stimulator was limited in options and current capacity. We really wanted to integrate the raw EMG display, increase the quality of the audio amplifier and stimulator, and add some useful clinical features we learned would be helpful. We optimized the input cable lengths and the length of the electrode adaptors in order to create the “universal” surface electrode options that are available to clinicians using Myoguide. We are very grateful to all the clinicians who provided us with feedback during the development process. This resulted in the Myoguide you see today.

We learned quite a bit during this process. While we did carry out device development in the past with clinicians by our side, we have refined our approach. We spend a lot of time interviewing clinicians to find out about what’s needed, and there is a major human factors analysis. This outlines existing processes, workflows, and assesses what works and what’s missing. This sets the tone of the input specifications for the new devices we have been developing. Interim prototypes will go out to human factors teams for further study under real world conditions. Feedback leads to refinements before the final prototype is completed. This way we emerge with a better first round. Stay tuned!