The Evolution of Myoguide
The Myoguide™ EMG/ESTIM BoNT injection guidance system you see today started development in 2006, over 16 years ago. We asked movement disorder specialists about the value of a portable device, to support therapeutic toxin injections. This evolution timeline extended to our first regulatory clearance in 2007, for BTX Buddy! Who came up with that name?
It wasn’t until 2009 when we were able to go through the regulatory clearance again, with the Myoguide design you see today. Myoguide is continuously upgradable. This design component has always ensured that we were able to refine the user interface and expand functionality within the scope of our regulatory approval.
Where Did We Start?
Our first rendition of an injection guidance device was a wireless device that used an early version of Bluetooth, that proved inconvenient due to the need for a laptop. The first iPad was not even available until 2010! The technology worked well, but was inconvenient, based on available technology at the time. Ironically, we find ourselves revisiting this original concept, lately! Stay tuned!!
A New Approach
We needed another approach. We had a brief adventure using lean design concepts, 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 comprehensive guidance procedures.
Back to The Drawing Board
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. We improved the audio section. We chose to use two smaller high fidelity speakers to keep the depth of the device “thin”. The stimulator had limited options and current capacity.
We learned that it was important 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 were finally turning the corner into the Myoguide design zone.
Input Cable Lengths
The input cable lengths were optimized, 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.
If you ever wondered how we arrived at the specifications for the input cable and adapter cable lengths, it was due to end user feedback and observations movement disorder clinics. This work allowed us to arrive at the current design for 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 always interact with clinicians, in order to ascertain their wants and needs. We do carry out human factors analysis. This outlines existing processes, workflows, and assesses what works and what’s missing.
This helps us determine 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.
We are always open to customer feedback and ideas to improve workflow. This way we emerge with a better clinical experience for both our clinician customers and their patients. Stay tuned!
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