00:00:05:11 - 00:00:08:23 Unknown Welcome to the podcast. 00:00:09:01 - 00:00:15:18 Unknown And everybody welcome back to the hard part. I'm your host DeAndre Haruka's the usual suspect. Grant Chapman. Back at it again. 00:00:15:19 - 00:00:36:21 Unknown So soon. So soon is almost like here every single week. Yep. So super excited. Today we have Josh and Herbie from Articulate Medical Labs and these guys. I'm honestly a huge fan of their technology, having had 3 or 4 different knee surgeries in my life. Every time we have a conversation, I'm like, man, I really wish I had your guys's technology when I was recovering. 00:00:37:00 - 00:00:41:15 Unknown But for those who for those who are listening, who are less familiar with you guys, love you. To kick it off on a quick 00:00:41:17 - 00:00:50:04 Unknown intro, sure. My name is Joshua Reynolds. I'm co-founder and CEO of Articulate Labs here. I'm the technical side of CEO. 00:00:50:06 - 00:00:55:12 Unknown Awesome, awesome. And so what does Articulate Labs do for those who need the entry level elevator 00:00:55:17 - 00:00:56:12 Unknown pitch? 00:00:56:14 - 00:01:26:16 Unknown All right. The Articulate Labs builds wearable devices to help turn everyday activity into physical therapy, and in particular, strength training and therapy throughout everyday activity using movement. Synchronous electrical muscle stimulation. The goal with the technology is to effectively augment your activity as you're walking your dog, shopping for groceries, getting in and out of your car, turning those into necessary strength training repetitions outside of a physical therapy clinical gym. 00:01:26:18 - 00:01:42:00 Unknown First place we're applying that you know DeAndre was was mentioning is addressing quadriceps muscle weakness and dysfunction for people who are coping with chronic conditions, of which there are 15 million plus in the US, plus another 00:01:42:02 - 00:01:49:01 Unknown million recovering from some form of knee surgery every year. Awesome. And so this is not something you're going to just strap on and do. 00:01:49:01 - 00:01:57:18 Unknown This is synchronous. So it's when you're moving it's actively firing the muscles to work them out slightly harder than they would just through general activity to get you that strength rain that you need. 00:01:57:18 - 00:02:16:11 Unknown Yeah, it's borne out of existing research that we've seen both Herbie's Herbie's lived experience plus what's what's published and saw that electrical muscle stimulation combined with voluntary muscle activation leads to far better strength games than stimulation applied passively. 00:02:16:13 - 00:02:34:00 Unknown The the challenge and when we talk a little bit about Herbie story is the vast majority of electrical stimulation as it exists right now is on preprogramed stimulation sequences. And you are moving your limb, flexing your muscle in time with the stimulation 00:02:34:04 - 00:02:38:15 Unknown pulses, so you have to time it manually to have the stem pulses do what they're supposed to be doing. 00:02:38:16 - 00:02:56:23 Unknown Yes. Got it. And that's different than you guys where you guys are timing the stems based on the user's movement. Absolutely. That's awesome. So and I think one of the coolest parts is you don't have to be stationary, right? You don't have to be. You don't have to be at a party laying down, like with all the stickers on, you can actually just be recovering your leg on as you're walking around in daily life. 00:02:57:00 - 00:02:57:07 Unknown Is that 00:02:57:07 - 00:03:14:12 Unknown right? Yeah. In fact, it was funny. This, this this morning when we were running a demo. We have someone who's wearing the device and is standing still and is looking at is like, so what does it do? Like, when does it start? It's not doing anything. It's not going to do anything right now like this. This is not that. 00:03:14:12 - 00:03:23:19 Unknown That's been the you the standard of care both with the existing muscle stimulation devices. And then you're you're kind of fly by night as seen on TV type 00:03:23:19 - 00:03:30:07 Unknown of of jobs, you know. Yeah. The AB shocker 6000 give you a six pack while you drink a beer. Exactly where it's like 00:03:30:09 - 00:03:32:07 Unknown the the less you do, the better. 00:03:32:09 - 00:03:56:23 Unknown We're here. We're we're up front saying this isn't going to do anything for you. If you stay still, you need to get up. You need to move. And we are expecting that we're going to attract a population that seeks to achieve those goals, that is not strictly looking to not strictly looking to get from the couch to the refrigerator and back. 00:03:57:04 - 00:04:07:23 Unknown But, you know, being, you know, being physically capable of maintaining, maintaining their independence, you know, being able to travel, being able to care for the level so and so 00:04:08:04 - 00:04:14:10 Unknown forth. Well, I think the the going through your eyes is, you know, I've seen some decks so I can pull some, some questions out of here that I know you guys answer. 00:04:14:10 - 00:04:35:10 Unknown But the neat part that I always saw was that the strength training wasn't just important for time to recovery, it was important for recovering properly. And I think that was the most unique thing that I hadn't heard about in other, you know, therapies that you guys are nailing because you're doing it synchronously. You're preventing the bad habits from forming, from having a, you know, a atrophied muscle after a surgery or something like that. 00:04:35:11 - 00:04:59:02 Unknown You're rapidly as fast as you can get the muscles back to the strength they should be. So you don't develop a walking the wrong way, talking about, you know, your bow legged step for a bit. Oh, obviously not need. Yeah. Yeah, totally. I love you guys to dive into this a bit, but I learned this whenever we were having a conversation before about if you don't actually recover all the muscles at once, you can actually start to have kind of have a knock need effect, right? 00:04:59:02 - 00:05:08:03 Unknown Because part of the muscle is pulling a bit more than the other one. That can actually lead to more, obviously more long term issues with the knee. Can you guys dive into that a little bit and how that's solving that problem? 00:05:08:08 - 00:05:16:04 Unknown Well, a lot of those problems, a lot of new problems. A lot of NeoStrata arthritis is caused by mistimed in the first place. 00:05:16:06 - 00:05:43:00 Unknown Common theory on patrol for more pain is that the medial, the muscle in the middle of the leg, is firing late. And if you fire it earlier and all of a sudden you don't have knee pain. And we did see evidence of that in one of our trials. But it I guess we're concentrating on individual muscles so as to be able to treat that knee as a 3D object instead of a 2D, as is commonly thought of. 00:05:43:04 - 00:05:56:03 Unknown Most people say this is a hinge. What we're doing is deliberately staying away from the prime mover of the of the meat. We're deliberately getting the side muscles so that we can create torque as necessary to keep things straight. And 00:05:56:03 - 00:06:01:12 Unknown this is like debility, and being stable and straight is more important than being strong. The client stares. Oh, yes. 00:06:01:14 - 00:06:04:09 Unknown Because. Because that's the beauty will prevent further injury. 00:06:04:11 - 00:06:10:03 Unknown It does. It doesn't look good way. And the thing that's predicting where the muscles and 00:06:10:03 - 00:06:19:11 Unknown what are they protecting outside of the muscles like is this protecting the joint and the cartilage. And you know, is that the key thing that's causing the pain is ironically, not muscles. It's what the muscles aren't guarding against. 00:06:19:15 - 00:06:26:16 Unknown Right. That's exactly it. It's an interference. And and eventually you'll work it in the cartilage, then you're interference with. Well, 00:06:26:18 - 00:06:41:21 Unknown that's even more fun. I, I couldn't imagine. Yeah. And so, you know, you guys have been working on this for quite some time, but a really cool startup journey. I think part of that is there's this mismatch between what the market thinks and knows what they want and what is coming. 00:06:41:21 - 00:07:00:12 Unknown And I think you guys are at that tip of the spear trying to solve that medical breakthrough that isn't the, painkiller. This is the long term fix, right? And so how has that journey been for you guys to find your go to market play? Who are you going to find that is your cheerleader on the customer side and what you're doing because you know, you're selling a medical device? 00:07:00:12 - 00:07:02:17 Unknown Who is the pathway to get to the end 00:07:02:22 - 00:07:10:21 Unknown patient for you guys this is hospitals. So that changes from almost year to year. So 00:07:11:00 - 00:07:17:13 Unknown far the story of startup. We learn new things every day. Yeah yeah. And but it's also you know the market 00:07:17:15 - 00:07:22:23 Unknown changes. Yeah. Administrations change. Oh you know I guess that does have a huge impact on it doesn't it. 00:07:23:00 - 00:07:50:08 Unknown Yeah. So for instance, you know, 2 or 3 years ago, we are seeing tremendous, typical we're, we're interpreting as significant demand signal out of the armed forces with regards to interest in our in our devices. And it's not that that has diminished as much as it hasn't scaled. And, you know, and we just also run into various administrative issues. 00:07:50:10 - 00:08:14:05 Unknown You know, we just had someone, you know, that was really geeked about about working with us on a proposal to the Air Force and, you know, come back to us yesterday and say, look, I'm, I'm getting shipped out to a new, new position, a new, new Air Force base. When that happens, I'm basically, you know, leaving you high and dry. 00:08:14:09 - 00:08:20:11 Unknown There's no one to hand off the relationship to. Yeah. Well, and and he's he's been up front soon. This 00:08:20:11 - 00:08:32:22 Unknown handoff is not going to work like I've done this before. This is not going to fly. Everyone's going to be miserable. You know, so we're better off just, you know, ping me in a year when I'm in 00:08:33:00 - 00:08:34:16 Unknown my new spot and we'll try it in. 00:08:34:16 - 00:08:56:21 Unknown And he's established enough to have the political capital locally to go forward with working with you guys. Yeah, yeah, yeah. And this is the, the political side, but of working with any defense contract. Right. Everyone thinks it's bureaucracy and red tape in process, but it's still relational. It's no different than raising money. You're no different getting your initial beachhead sales at the hospital. 00:08:56:21 - 00:09:03:22 Unknown It's actually about relationships. The only difference is these people don't control where they work, right? They get moved around, they get shipped out. And that's 00:09:04:03 - 00:09:27:17 Unknown the the challenge. Yeah. So that, you know, that I brought that up only to say, you know, our thought was for, for a second was, okay, we're gonna we're gonna make the military our beachhead, you know, and we're going to sell into facilities where we have human performance optimization, protection in the forest and family, various types of physical, physical fitness and rehabilitation. 00:09:27:19 - 00:09:54:13 Unknown And while we're still getting, we're still seeing some traction there. It's really fallen back from where we expected it to be by this point, such that we're kind of back to the original plan of focusing predominantly on pre post knee replacement care, because that's where there's the greatest strength and activation deficits that are, that are measured, as well as the greatest cost costs to to control. 00:09:54:14 - 00:10:21:13 Unknown Oh absolutely. But then the you know then reimbursement becomes a consideration again. And where the durable medical equipment space where there has been a lot of fraud, wasted use in the past and in the recent past, the federal government, I think this is just just a handful of months ago, put a six month moratorium on any new durable medical equipment suppliers getting getting greenlit, greenlit. 00:10:21:14 - 00:10:46:23 Unknown Yeah. So, you know, so, you know, in that we're, you know, pivot back to being a DME, DME manufacturer. Oh, wait, maybe not. So then we you look at others in the space, particularly remote virtual physical therapy like Sword Health and Hinge Health. Buffy. Simplify health. They're they're not messing with reimbursement at all. They're not messing with the hospitals at all. 00:10:47:01 - 00:10:52:03 Unknown Never getting out of pocket. Yeah, out of pocket or VA or 00:10:52:05 - 00:10:58:07 Unknown self-insured companies. But you know, that's so that kind 00:10:58:07 - 00:11:07:21 Unknown of slowly pivoting, pivoting there and trying to figure out what is our, what is our funnel going to look like and how are we going, where are we going to meet these people, how we're going to sell them? 00:11:07:22 - 00:11:15:17 Unknown How are we going to how are we going to close trying to figure trying to figure that out while also trying to figure out how we're going to raise money and, 00:11:15:20 - 00:11:21:23 Unknown you know, the hardware and run a company and. Yeah. Yeah. So it's it's 00:11:22:01 - 00:11:36:12 Unknown it's been it's been a challenge, you know, and some of the truth is that there have there have been places where we haven't been able to move fast enough or build fast enough, or scale fast enough to really make use of the of the opportunities that were there and 00:11:36:13 - 00:11:37:17 Unknown the connections and everything. 00:11:37:18 - 00:11:43:02 Unknown Yes. Oh. But then, you know, some some of it was just, 00:11:43:04 - 00:12:19:14 Unknown you know, the terrain just just moved in with your feet, under your feet. Yeah. If only we had stability. Yeah, boy. Cool. Yeah. So. Yeah, it's it's what what it means is, is in, you know, we just have multiple go to market strategies, and we we don't we're not pursuing all of them simultaneously, but minimally we are prepared for those those contingencies for like better term in terms, you know, we we meet individuals or companies or larger organizations that have interest in a particular area. 00:12:19:14 - 00:12:20:18 Unknown We've got an argument 00:12:20:18 - 00:12:34:11 Unknown waiting for them as to why they should take take a look at what we're doing. Absolutely. Now, one of the other questions I had to Josh and Herbie is just around that fundraising journey. Can I dive into that a little bit and what that landscape has been like for you guys over, over the time? 00:12:34:13 - 00:12:41:13 Unknown I'll own up to the fact that first, I'm, I struggle, 00:12:41:15 - 00:12:49:22 Unknown everybody struggles with wondering. Nobody enjoys fundraising. There's a few crazy people. That is the only thing that I like, but no one likes most people. Yeah. 00:12:50:00 - 00:13:08:02 Unknown It takes someone different, and I. I adapted parts of myself to fit, but I haven't adapted enough. Particularly the the guilt and the shame of asking anyone for anything that's, you know, it's it's a it's a real struggle. 00:13:08:03 - 00:13:35:11 Unknown And, you know, as a result, we've, we've kind of we've wound up finding money out, you know, everywhere else. But with traditional investors, we have we have pulled in some, some individual angel funding predominantly from investors in Herbie's last, last startup. But otherwise, you know, the majority of our money has has come from non grants of Army and Air force and it's come from awards. 00:13:35:11 - 00:13:50:09 Unknown It's come from investment from accelerators like Techstars and M hub. You know so we can we can say that we're a venture backed organization. But you know we we truthfully never done the, 00:13:50:11 - 00:13:57:18 Unknown you know, full court press, you know, 80 hours a week. We're going to go close around in the next 60 days or die trying. Yeah. 00:13:57:19 - 00:13:59:03 Unknown Right. Yeah. 00:13:59:05 - 00:14:22:14 Unknown It's and it's it's personally, it's difficult for me to do that when there's so many other things going on and, and, and, and product development and operations, finance and clinical trial management, regulatory reimbursement and that, you know, when you're having these conversations and someone says, well, I don't think you invest far enough in area X, Y, or Z. 00:14:22:15 - 00:14:57:13 Unknown So every movement I'm spending talking to you, I could have been addressing that problem. Yeah. But the problem is I come in with that mindset before even having that conversation and I, I, I think I sort of, short circuit myself there. So I'm working through not just making sure that we got the best business plan possible, but also feeling that level of comfort and confidence to be able to go out and contact folks about what we're doing and to to present it as an opportunity as opposed to, 00:14:57:17 - 00:15:01:05 Unknown you know, having our hands out and treating this like this, you know, poverty. 00:15:01:06 - 00:15:18:12 Unknown And it's such a wild dichotomy as a founder having to tread the line between the two things hand out. And this is the best opportunity you've ever had because you want to do it honestly. Like, I think this is going to be awesome, otherwise I wouldn't be doing this. I think what we're doing is the best thing ever, or I wouldn't be spending my whole life doing this on the other side. 00:15:18:13 - 00:15:37:06 Unknown Like, I have no idea if we're going to make everyone millionaires or we're going to light all the money on fire trying. And that that dichotomy most founders don't talk about. So I'm really glad that you brought that up, that guilt side, because it's so rarely talked about when, I mean, you've raised money and I've held tons of founders actually go through the, you know, the sage, the grief of fundraising. 00:15:37:07 - 00:15:54:07 Unknown Sure. And I think it's the emotional side of that journey is almost, if not more important than, hey, do you have the right metrics in your pitch deck? Sure. No, I would tend to agree. I think one of the things I was really hard for me was you absolutely throw the burden once you start raising capital, right? Especially from angels VCs as well. 00:15:54:07 - 00:16:09:05 Unknown It really doesn't matter where you're getting the capital from, but you almost feel, especially if you're early on, if you haven't been through that kind of the VC, I don't know, rigamarole before you. Yeah, you kind of feel like, man, I owe these people. You know, they gave me all this money and I've lived on I've lived $500,000 on fire. 00:16:09:06 - 00:16:26:13 Unknown We're not where we want to be. But I guess some really good advice. I think it might have been from a YouTube video I watched from from mentor. I really can't, can't remember. But you're not taking a handout. When you raise capital. They're buying something from you. It's an exchange. You're giving me capital and you're getting equity in this company. 00:16:26:14 - 00:16:42:20 Unknown We both have deemed that it's worth insert this amount of money, that it's probably not. But we're going to say that's our valuation and we're going to move on the lottery ticket you're selling today. That's right. And so whether it's a, you know, a win or a loss when it comes to raising money, you almost have to kind of start looking at it like that, like, hey, they're expecting to lose this money, right? 00:16:42:21 - 00:16:59:03 Unknown Whenever you bet on a startup, right. If you're betting on one, if you're an angel investor or you're like an investor at all worth your salt and you're going to be betting on five companies, you're going to be a really bad investor because those five companies are going to fail, statistically speaking, right. So you need to have a be casting away wider net invest in ten, 20, 30 companies. 00:16:59:03 - 00:17:15:21 Unknown And so you can have the one that makes up for the other 29 didn't work out. But that took me a long time to learn on getting over that guilt. I mean, I used to just used to keep me up. I did a monthly investor update deck that, you know, if the metrics weren't exactly where I wanted them to be, I just my stomach would be curling two weeks ahead of time. 00:17:15:21 - 00:17:31:10 Unknown And then it gave me two weeks to do some work. And then in the very next two weeks after that, I would be freaking out again and then going and doing the following month. And I'm sure you guys have felt that before. So yeah, I mean, yeah, I would say that it takes quite a while to get past a point of thinking, no, this isn't a handout. 00:17:31:11 - 00:17:36:14 Unknown You're buying something and we're on this road together. If it works out, great. And if it doesn't, then that was the bet all along, 00:17:36:17 - 00:17:56:13 Unknown right? You know, but it's it's interesting that, you know, that that that mindset has really helped me with the grant writing side of things. You know, our experience working with, you know, we have a $1.3 million award through the Medical Technology Enterprise Consortium for full disclosure. 00:17:56:13 - 00:18:21:13 Unknown They were a sub grantee. But we we worked with the Henry M Jackson Foundation for Advancing Military Medicine, as well as Keller Army Community Hospital at West Point. All of us worked together on on this proposal and got it. And then we got to actually see people using the device and, you know, getting, you know, getting requests for, for these devices when I have one basically. 00:18:21:14 - 00:18:52:07 Unknown Yeah. And you know, so then you're, you're actually creating value for somebody else, you know, and particularly, you know, you know, being someone who's athletic. Everyone here has been been been an athlete. There's, you know, we're we're working with folks who are coming off of ACL reconstruction. That means that minimally, for the next nine months, they are not the person they were yesterday. 00:18:52:09 - 00:19:28:03 Unknown You know, in terms of their physical capability, a chunk of their identity is gone. Their ability to contribute to their the team or their craft. Yeah. Is is gone. Like in, in the blink of an eye. Being able to do something about that is, is really fulfilling and having you know, it's we've started to see that there is a connection between bringing money in and creating value for somebody where I think a lot of fundraising, that isn't always the case, you know, and some of it is understandable. 00:19:28:09 - 00:19:34:09 Unknown You know, if you're like pre-seed, you're basically selling vaporware and hope and dreams. 00:19:34:10 - 00:19:39:13 Unknown But, you know, for seeing 00:19:39:16 - 00:20:03:13 Unknown stuff like in, you know, fintech, B2B, SaaS now various wrappers around Llms where it's, it's arbitrage and it's, just, you know, the what seems like the most deeply cynical belief that better things aren't possible. We can just slow the, the drop into oblivion. 00:20:03:15 - 00:20:23:14 Unknown And, and, you know, being able to get outside of that and, and do something that we think is actually truly, you know, creative and helpful is, made us a lot more confident, made me a lot more confident, maybe a lot more capable of bringing in money. But but again, primarily in that clinical trial 00:20:23:16 - 00:20:27:03 Unknown pilot demo type of situation. 00:20:27:05 - 00:20:39:07 Unknown Well it's it's in the fact that we're a heart attack on money means you actually need even more capital than your software counterparts, even if they're also doing something good and is going to make people's lives better. You still have it harder. 00:20:39:11 - 00:20:46:21 Unknown Yeah. And and the other side of it is, you know, it's it's either you have a ton of capital coming in or you have something. 00:20:46:22 - 00:21:00:12 Unknown You have what, what Herbie's done, which has been pretty much one man hardware firmware form factor development, which didn't happen instantly. So then there was questions about, well, you guys have been around for forever and you haven't done X, Y and Z. It's like, well, 00:21:00:14 - 00:21:04:15 Unknown we didn't have the money. We had to use the time. We almost bootstrapped this thing, right? 00:21:04:15 - 00:21:22:17 Unknown Yeah, yeah. And I think that that's the, the, the next half of the, the podcast I like to dive into because we haven't had a really deep technical episode in a couple, and you guys were the ones I knew I could pull this on. So, for, for the users or the user, the listeners, I'd love to dive into exactly what you can share about your device and what it does. 00:21:22:18 - 00:21:38:06 Unknown And then let's jump into how you had to build this thing. I know you pulled some rabbits out of a couple of hats to make this thing work. So Herbie, what is, you know, for the users that are hardware, people that speak electronics and device. What are you guys doing in the device? What? Let's start at the high level. 00:21:38:07 - 00:21:38:16 Unknown Sure. 00:21:38:21 - 00:22:01:15 Unknown Well. Highest level. We've got an inertial measurement unit up on the femur. We've got an inertial measurement unit down on the tibia. So we know what's going on spatially with that joint. You've got the two connections to it. We're running a two point load model inside two points because there are two kinds of load bearing surfaces inside the me watching that model. 00:22:01:17 - 00:22:23:04 Unknown Then as user moves, we're also watching to see what the angle is between the T between the femur and the tibia. Yep. When the joint is not loaded, when his foot is off the ground. Oh, awesome. We're taking that as our happy state. We'll say for the knee. Then we have the the physician or the PT hit a button on an app. 00:22:23:04 - 00:22:43:06 Unknown When that patient is actively doing something that's problematic, something that hurts or something that's going to cause damage, he hits a button on the app. When that when the patient is doing that, the device looks at those load vectors and says, okay, I'm going to remember those. And in the future, if I see these workers or something close to it 00:22:43:10 - 00:22:44:13 Unknown or heading that direction. 00:22:44:14 - 00:23:01:08 Unknown Yeah, heading that direction, we're going to stimulate. Okay. So we're going to fire the muscles. And then are you putting the electrodes on the same place for most people, or are you tuning the electrode placement for each individual based on their, you know, anatomy, morphology of what you're trying to solve for? 00:23:01:10 - 00:23:06:15 Unknown The form of stimulation we're using is a higher frequency a lot higher frequency than is usually used. 00:23:06:16 - 00:23:09:09 Unknown Okay. So we don't rely upon motor plants 00:23:09:11 - 00:23:26:03 Unknown okay. So you can just generally activate. Yeah. And it's let me translate this like layperson talk. You're not trying to turn on and off the muscle like you're the one turning it on. You're just saying a single hey everyone, let's go. And you're generally advertising guys, let's go. Not trying to mechanically stem with your electronics. 00:23:26:03 - 00:23:29:00 Unknown Is that closer to the fact if you're not being localized, are you, 00:23:29:04 - 00:23:46:02 Unknown you know, exciting the whole area. We are the whole area. But we do have a focus. Okay. Yeah. There is a focus in the in the muscle. Got it. So yeah, normally what I'll do is get the electrodes around that belly. And from where I stimulate the never recruit outward. 00:23:46:03 - 00:24:08:01 Unknown Got it. Okay. So it's like a radial outward that it's a drop off of some probably squared a cubic function, but it drops off from the, the location you're targeting. So you're, you know, the angle of the, the leg and the knee joint and you're training with the position of the clinician, the activities you want to stem right before or you want to either avoid or continue to promote. 00:24:08:03 - 00:24:21:08 Unknown And then your algorithm is watching the motion in real time. Looking for where approaching trigger guys. Let's get ready and then triggers muscles. Fire build strength prevents bad actions happening. Losing the stability. As you and I were talking about earlier, 00:24:21:10 - 00:24:26:17 Unknown how do you pull that off in something that you wear? It was rough. It took a while. Yeah. 00:24:26:19 - 00:24:30:10 Unknown And my neighbors are pretty used to me running around the block with strange things on 00:24:30:13 - 00:24:36:19 Unknown in a laptop in your hand. Probably. Almost. Really. It was. No, not the only other 00:24:36:19 - 00:24:50:01 Unknown piece that we really. Well, we ran into a huge obstacle with using low frequency stimulation because it relies on motor points. There's another downside to that is that long distance runners are really, really hard to stimulate with the low frequency 00:24:50:03 - 00:24:50:13 Unknown stimulator. 00:24:50:14 - 00:25:08:08 Unknown Oh, interesting. Yeah, I found that out in the gate lab out at Stanford. You found that out live? I found it out live. That's interesting. So is it like the people that are long distance runners, that have bustles that are very used to, you know, going long distance to are they tougher or is there some morphology that's different? 00:25:08:08 - 00:25:28:04 Unknown Yeah, there is a morphological difference. There's a lot to it. Just what most people got to it. But no, I mean we walked in. This is there was a researcher out there, had a really nice gait lab invited us out for a demo. So we go out and I was going to be the test subject. They said, well, you're an amputee. 00:25:28:05 - 00:25:47:06 Unknown You can't. Your gate is so screwed. We don't know how to track it. Right. So this won't work. I had our guy who was our sales at the time, a great guy. He he said, okay, well, I'll be the test subject. No big deal. You're sure it's on him? You're a device on him. And we couldn't line him up because he was a runner. 00:25:47:06 - 00:26:05:22 Unknown He was a runner. I was using love for extension. Just wouldn't work. So we went back and took a couple of months and figured out what was going on. I bought a box of EMG needles so I could throw needles into the muscle and find out, get deeper and find out what's going on. Where is it going? I figured that out. 00:26:06:00 - 00:26:18:13 Unknown Amazing losses in the leg. I mean, I could at the time, I was using, like 100 milliamps. Yeah, put 100 million amps at the surface. What's actually doing the work is the three milliamps. That makes it down to the core of the muscle. 00:26:18:18 - 00:26:25:12 Unknown So we work on on stem for a couple of other products, both for Stem and for detection of electro bioelectric signals. 00:26:25:12 - 00:26:47:05 Unknown And the fascinating thing about tissue, both electrically and thermally, is it's not uniform, right? Muscle and fat behave wildly differently. Skin its own damn animal, whether it's wet, dry, clammy, if you're young, if you're old. Like, what's crazy is the pigment of your skin and the age of the person radically change resistance of the skin tissue. What's not resistance? 00:26:47:06 - 00:27:09:07 Unknown Well, you're right, it's impedance and it's complex and it's. But yeah. So thank you for the correction. But it it changes both on the you know who you're treating and how are they doing. Are they sweaty. Are they dry. And all these things and calibrating for that when you're trying to sense or to send power like three milliamps to the core of the leg, you might have to overdrive $100 million. 00:27:09:08 - 00:27:20:05 Unknown And this is so hard to do. So how did you learn to modulate? Or is your higher frequency helping you push through the impedance of the body to make it more uniform, to get more power where you keep it? 00:27:20:06 - 00:27:28:14 Unknown Yeah. No, I mean then well, the impedance really comes from capacitance, most of it. Because I mean, if you look at resistance you might be up a couple hundred K. 00:27:28:15 - 00:27:41:13 Unknown Yeah. There's not a not a lot of Corinthia by taking the three cup I'm staying away from the C fibers down in the bottom. Yep. So that gets the pain down a little bit. And at the higher frequency I can put a lot more energy into that. 00:27:41:15 - 00:27:46:21 Unknown Most interesting because it's a capacitor passive reactance formula one over two Pi FC. 00:27:46:23 - 00:28:07:03 Unknown And humans are big salty creatures. So you hold is ionic movement that is good for the past and bad for current caring. Interesting. Yeah. But that that was a major development. Yeah. No I bet. And so you got a high frequency stem and a mobile device and you got a battery. Power it and you have to do all your math on device. 00:28:07:05 - 00:28:24:21 Unknown What what was the challenge on compute and timing? We talked about this. I you know, I've been baited with this question because I found it fascinating the first time, you know, how are you getting things to trigger at the right time if human gate is slow on human terms, but the electrical signals that are coming through are quite fast for you to trigger on. 00:28:24:21 - 00:28:28:07 Unknown So how are you grabbing that? 00:28:28:09 - 00:28:47:03 Unknown Years and years ago, I was consulting the General Motors research. They gave me a car with a manual transmission and a five speed beautiful transmission. And they said, we want this to to act like an automatic, so fine. So I put a shaft encoder on the thing and started playing with it. 00:28:47:04 - 00:29:02:04 Unknown Put motors on the transmission, shift gears for it, motor on the clutch, did all that. I was using it at that time. I was using regular conventional programing techniques, you know, straight code. Everything was in December back then, 00:29:02:06 - 00:29:08:00 Unknown but nonetheless the machines were slow. So okay, so you had to be fast. You had to 00:29:08:00 - 00:29:17:09 Unknown be fast. I ran into trouble with that because what I found is that, well, clearances in a trance changed dramatically with temperature 00:29:17:11 - 00:29:19:16 Unknown and they changed dramatically with. 00:29:19:18 - 00:29:32:02 Unknown Yeah, well in the in the resistance, mechanical resistance of the shift knob with oil temp is crazy different than manual. Oh yeah. So the talk you needed to put in your motors changed over temp and how hot it was and how warmed up the car is 00:29:32:04 - 00:29:37:15 Unknown man. So I'm looking at this and then pulling my head because this thing just is not reproducible. 00:29:37:17 - 00:29:55:11 Unknown Then I realized that, well, the computers, it's got sensors out there. The CPU knows hell of a lot better than I do. What's going on with this trans? So I started using adaptive code at that point. Back then. We're using things like genetic algorithms, things like this. These are forerunners were what people would call I mean 00:29:55:17 - 00:29:57:05 Unknown like machine learning basically. 00:29:57:06 - 00:30:05:15 Unknown Well, yeah, of the sort. Yeah. The precursor to what we'd call machine learning was the genetic algorithms that would update their algorithm, but not open ended. 00:30:05:15 - 00:30:22:09 Unknown Right. Yeah. Yeah. That here is to calculate also because you want to see the behavior of the set. So that got really interesting because it worked worked really well. I expanded that out to a real time operating system because I then moved on to consulting to Chrysler. 00:30:22:09 - 00:30:38:05 Unknown And on one project, it was a crash project. They gave me a bunch of programmers to help on the project. We didn't have a lot of experience, so I had to be able to protect against inexperienced programmers and get a crash project out real quick. 00:30:38:07 - 00:31:02:09 Unknown It caused me to write a bunch of functions in this operating system that appear to be runtime code. The appear to be actually generating something that's going to execute. They do not. They just call function. Know what they do. I put a task manager behind everything that it was the one who's actually doing that exercise. So his code that's been vetted very firmly. 00:31:02:10 - 00:31:21:18 Unknown I mean, we beat the hell out of that code first so we know it's good, but then if somebody messes it up, we've got protection. Got it. We're using that real time operating system or an extension of it in the device. And what it gives me, though, it allows me to avoid a lot of the time feeds in a project, 00:31:21:20 - 00:31:26:10 Unknown interrupts or one thing that I do not like. 00:31:26:12 - 00:31:28:13 Unknown I mean, you hold of joy. 00:31:28:18 - 00:31:34:19 Unknown No, I mean, why do you want to spend all this time remembering where you came from, go 00:31:34:21 - 00:31:41:01 Unknown off, dropped everything, do something sporadically, and then we remember everything that you were doing, right? I 00:31:41:01 - 00:31:49:02 Unknown mean, it's it's a total waste of time. Much the same with a lot of communication stuff, using semaphores. Same thing. 00:31:49:02 - 00:32:10:11 Unknown You spend more time in the Center force and you do in your actual code, right? Why do you spend with those? It allows me to get a very, very quick response to something. It also allows me to create a multitasking operating environment for coders who don't know how to write environments like that. Yeah. So they're writing multitasking code and they don't know it. 00:32:10:13 - 00:32:18:05 Unknown Yeah, they've got bumpers on. They don't think they're writing something as complex. And you're you put the guardrails up so they don't override each other in an action. They don't. The timing isn't 00:32:18:08 - 00:32:32:14 Unknown crash. Damn. I put that into a state structure so that then I've got higher, higher capability, higher permissions level that I can use to protect code running at a lower level. 00:32:32:15 - 00:32:36:18 Unknown Got it. So I've got guardrails or a place to put guardrails if I want them. So 00:32:36:18 - 00:32:50:18 Unknown you don't. So you don't end up calling one function something else happening at the same time that needs the memory or the access to the Gpio that the other function is using. Got it. Yeah. This allows you to get because you guys are also not only stimulating the muscles. 00:32:50:20 - 00:32:54:14 Unknown Are you reading anything from back on those electrode channels. Any feedback loops? 00:32:54:14 - 00:33:05:03 Unknown Yeah, we are pulling back EMG signals. We only future will be using acoustic as well. Oh yeah. Because well acoustic priorities got a much better dynamic 00:33:05:05 - 00:33:11:13 Unknown range. Fascinating. Yeah. All I would not have known that. I have never dug into it. That's crazy. No, 00:33:11:16 - 00:33:15:00 Unknown I, I don't understand why more people aren't using AMG, to be honest. 00:33:15:01 - 00:33:22:21 Unknown So explain that for all of us, like we're five. No, no, I mean, what you've got a it's a low level signal. 00:33:22:23 - 00:33:32:01 Unknown You don't know where it came from because it's following Ohm's law, right? Yeah. You're just you got out there and you're picking up electrical signals moving around. Yeah. It's wet finger in there. Yep. And 00:33:32:05 - 00:33:33:20 Unknown it's maybe ten microphones, right? 00:33:33:21 - 00:33:46:12 Unknown Yeah. It's really tiny. You're having to amplify the piss out of it to read it. Yeah. On the other hand, though, for AMG, I can take a piece of permanently polarized film, a film mic, throw it on the skin, 00:33:46:14 - 00:33:56:11 Unknown exercise the quad or whatever the muscle, and I'll get a volt signal. Interesting. And it's reacting to the like the acoustic, like the actual, like pressure wave. 00:33:56:13 - 00:34:02:17 Unknown Well, no muscles make sound. They make a rumble when you contract them. You can hear. Yeah. 00:34:02:19 - 00:34:08:17 Unknown Oh, I've got to go try this now scope and go do something. That's hilarious. Yeah. The guy who originally 00:34:08:17 - 00:34:14:23 Unknown found it, he was over, I think it was in Great Britain, described that noise as cobblestone roads. 00:34:15:03 - 00:34:23:15 Unknown Yeah. That is so cool. So you can listen to the sound to detect firing, not firing things going on that is really, really cool. 00:34:23:19 - 00:34:32:00 Unknown Yeah. How did that. We've we pulled out fatigue, for one thing. Another is your strength. What's the contract? How force? It's going on. 00:34:32:01 - 00:34:48:10 Unknown How loud is this contraction? Yeah. That is so neat. We have had another guest on the podcast that is doing something in the IMU space that can tell runner fatigue from a single IMU location on the body that draws, they call a force portrait. 00:34:48:10 - 00:35:09:13 Unknown So they basically take the motion of your sacrum and they are drawing a three dimensional force portrait of where all the accelerations are going in your, in your hips. And from that they can tell if you're starting to get fatigued as long as you ran with it when you weren't fatigue first. And it's amazing that it the their algorithm couldn't find it just with cure like machine learning on the on the the math side. 00:35:09:14 - 00:35:31:00 Unknown But they start doing an image comparison to this portrait that was drawing the force vector. And all of a sudden their algorithms picking out, oh, you're getting fatigued. Your favorite on your right side. Such a cool aspect that, you know, humans are visual creatures. We interpret math better on graphs, right? Most humans interpret math veterans visual. So do computers, which is fine, mind blowing. 00:35:31:01 - 00:35:46:03 Unknown But I think this is so cool that you are able to use this acoustic signal to get way more resolution than what we all would have thought would be easier electrically, because we think of muscles being things that your brain fires will signals, but it's louder than it is electrically loud, which is cool. 00:35:46:04 - 00:35:49:10 Unknown No, it is cool. It's also caused an effect. 00:35:49:11 - 00:36:04:11 Unknown Right. So it doesn't know anything here is to diminish the necessarily the value of EMG. We're just looking at EMG is the signal impulse to the precursor is the precursor. That's what drives the muscle to contract. AMG is actually giving you some 00:36:04:15 - 00:36:10:17 Unknown feedback on what is that muscle doing. It did contract it and how much and where. That's cool. 00:36:10:21 - 00:36:30:08 Unknown Yeah, but I mean, to do all that, you need quick processing and you need to be able to know when your tasks are going to get there. So I moved away from a control flow process entirely. We're using a data flow system by going to a data flow system follows the data. It does not follow a control sequence that you've ordained. 00:36:30:09 - 00:36:50:12 Unknown Yeah. Therefore it's not interesting. You don't know. You can't flowchart the thing to tell you it's going to happen next. Yeah. So that means people sometimes nervous. But by the same token, the other side of that is that you can directly follow the data and you can map exactly from any movement down to the effect instantly with that kind of a system. 00:36:50:12 - 00:37:08:12 Unknown And it's given me a system. Right now we're using a legacy processor because I had just ported to a contemporary processor encoded yet, so we couldn't get them. Of course not. Went back to the legacy processor in on that legacy processor. Right now I'm running at a 50 microsecond latency before task 00:37:08:14 - 00:37:11:04 Unknown runs. That's nuts. And so you got that all running. 00:37:11:04 - 00:37:32:08 Unknown And you need that to capture the gate. So you fire at the right time. So it's not fighting me as I'm walking or running with this device on. Right, right. It's feeling what I call a magic carpet moment. Right. We were building an e-bike before they were cool and old school e-bikes. You'd start pedaling and you'd feel the motor kick in and push you along, and you'd stop pedaling, and it would still push you for another second or half second, and then it would stop. 00:37:32:10 - 00:37:50:22 Unknown Which doesn't sound like a lot, but it's really unnerving when you're wanting to slow down. And we were able, when we're building e-bike to get a control loop, that was in time, we know for sensor torque sensor in the crank. So when you pressed harder with your right leg than you and your left, we provided more talk on the right downstroke than the left, and it felt like you were in an Iron Man suit. 00:37:50:23 - 00:37:56:07 Unknown He was just responding to you as a bicycle. You've done the same thing, but for stimulating my own heart muscles. 00:37:56:11 - 00:38:33:17 Unknown That's super cool. Yeah, it's it's necessary because even though we we think everyone walks the exact same way, there are minuscule differences in, in position, motion, acceleration of the limbs as people are walking. Now you add in an injury for which one that that has its own gait impacts, and then over time you have compensatory movements being developed as people try to take load off of a of of an injured joint and wind up putting more load on one another. 00:38:33:17 - 00:39:03:06 Unknown And we saw this in the feasibility study, where it's not just that people had people who had her knees, didn't, didn't bend it. They also might basically pivot on the good leg and lift up one whole side of their body to move, or they might drag them like behind them. They, they there's all kinds of strategies that people unconsciously develop, and you can't guess what those are going to be from the developer's edge. 00:39:03:08 - 00:39:18:00 Unknown You need to have something that's going to be able to learn from and adapt to those those situations, rather than being prescriptive about how someone is walking right now, how they should be walking in the future. 00:39:18:02 - 00:39:25:17 Unknown Well, I think this is all tying into the future of med device right now that we are seeing in the industry and you guys are doing before it was cool. 00:39:25:19 - 00:39:46:03 Unknown What we're seeing is software has become ubiquitous. Anyone can write software, those cool things. Arbitrage is the most useful thing to software does these days. But hardware because machine learning in the computers, like the upload side in the databases, has gotten so good and so cheap and so easy to implement. Because we're standing on the shoulders of giants. 00:39:46:05 - 00:40:05:23 Unknown We can call libraries that are open source that people wrote to go do autonomous driving or much more complex things. We can now take all this data from the med device world and crunch numbers on it and find patterns, find diagnoses coming on. You guys are probably collecting great data to learn. What does movement look like? How do you make this happen? 00:40:06:01 - 00:40:26:06 Unknown And we're entering this world where the medical devices not only are acting in the moment to treat their, they're diagnosing what's wrong, helping someone understand mechanics of what's going on inside. Kind of like radiology used to be that the key for us. Can we now sense it by watching you move and walk. And you can also do monitoring post operation, not just the recovery. 00:40:26:07 - 00:40:46:13 Unknown Hey, telling the doctor, is the person recovering? Are they doing their steps? Are they doing their thing? And this is what falls into your knee world sales is like man, what people love to see in med device is not a 1 in 1 shot in the pan device. They want to see something that can help, you know, diagnose, treat and then long term monitor because that's where long term value comes for patients, right? 00:40:46:14 - 00:41:02:06 Unknown It isn't just a one pill you take to make it go away. It is the thing that helps you figure out you need the pill. It is the pill. And make sure you took the pill. And I think you and I have seen this all over that. These med device companies are having way easier time to go to market because they're selling a bigger picture. 00:41:02:09 - 00:41:09:22 Unknown Yeah, I would agree. So I think that's super cool to watch. You guys have all the pieces of the bigger picture. 00:41:10:00 - 00:41:47:14 Unknown It's even still was still there still struggles to get through there. I think in particular in the in the space of physical medicine, which is tertiary. It's it's difficult when we are talking with a potential hospital that's reaching out, looking for care solutions for the remote or austere patients that, you know, at the end of the day, they're they're kind of weighing a knee device versus something for better heart monitoring or better, you know, kidney monitoring, better respiratory monitoring and saying, well, what do I care what what someone's needs doing? 00:41:47:14 - 00:42:14:07 Unknown Even though lack of mobility may be a contributing factor to all of those co-morbidities that they're more freaked out about right now, but we still we still treat physiology even even though ambulation is, unbelievable. It's it's it's one of the gifts we just absolutely take for granted every day. But we still treated we we we treat it as a treat. 00:42:14:07 - 00:42:20:18 Unknown Physiology as a lower science. And we treat movement as nice to have not need to have. 00:42:20:18 - 00:42:38:22 Unknown Which is crazy because this nice to have prevents all the other comorbidities, comorbidities like being out of shape in your party vascular system or your pulmonary system, or even overweight or depressed. Right. Like insert all the higher things, you know, things that kill more people. 00:42:39:00 - 00:43:00:20 Unknown This is what actually ended in one of the desperate, because a lot of that can be prevented by having good movement. I would say in large part, most of it's actually prevented by moving. This is genetic. I mean, there's so many things about if you stop moving around and stop being active because you have an injured leg or knee or whatever that ends up being, you know, fast forward insert number of months later, maybe a couple to many, like lays bags of chips. 00:43:00:20 - 00:43:03:01 Unknown You're going to be, you know, maybe having a couple issues. Right. 00:43:03:06 - 00:43:24:16 Unknown So yeah. So it's it's still we're still working on that that health economic value proposition on something that is closer to a vitamin than a pain pill and saying, if we can, you know, if we can improve quadriceps strength and or activation by extra, it's going to save you. 00:43:24:19 - 00:43:56:10 Unknown Why? Thousand or Z tens of thousands of dollars in treatment later. Yeah. And for the for the self-insured company then it's about lost productivity. You know, how how much quicker can you get someone back to work in sports medicine's return to sport in the military? Return to duty, return to load. All about maximizing, maximizing credibility, cutting time, and getting people back to doing what 00:43:56:16 - 00:43:58:02 Unknown you're paying them to do. 00:43:58:06 - 00:44:10:11 Unknown Yeah. And then one of the other questions I have is for those who are listening, what are some things that you guys have? Can they go follow you different places or different things you guys have coming up that you might want to shout out on the podcast here? Now 00:44:10:13 - 00:44:15:23 Unknown we are. We're bad at that. I'm bad at that. 00:44:16:01 - 00:44:25:06 Unknown We're I'm I told people I would be posting like once or twice a week on LinkedIn and I'm already that's one New Year's resolution that's already in the trash. 00:44:25:08 - 00:44:31:09 Unknown We can help you with this. Yeah. No, I'm I'm excited. This is why we do this. Yeah. 00:44:31:11 - 00:44:36:08 Unknown So, yeah, LinkedIn's were probably probably the place where we're most active. 00:44:36:08 - 00:45:04:18 Unknown We are trying to maintain physical presences at places that are going to be relevant. For instance, next week will be at the Army's Holistic Health and Fitness Symposium out in the Norfolk area. Will be at the Hard Tech Entrepreneurship Summit in Boston a few weeks after that. If it's if it's related to heart attack, it's related to physiology. 00:45:04:20 - 00:45:36:09 Unknown We'll try to be there. So that's, you know, the that intersection is a decent place of of how to how to find us. Otherwise, you know, both of us are, are pretty regular fixtures at the M hub facility in Chicago. Folks do enjoy coming by seeing seeing Herbie's workspace. And it's we. I enjoy watching people come by and ask for random things and being surprised that, you know, Herbie can can produce it from from a random bin in a in a corner. 00:45:36:11 - 00:45:37:20 Unknown So yeah, that's it. 00:45:37:22 - 00:46:05:00 Unknown That's, that's a couple, a couple places where we can be found. That's awesome. Go ahead, Grant, shout out to M hub for anyone listening. Articulate labs got a lab there. We've got an office there with Hunter there. So it is a really cool place to go do hard tech. If you're looking at starting a hard tech business and you're in the Midwest and looking to go towards the density of being surrounded by like minded, crazy people, I think ML hub is probably the best place to live west for it, not just because you can hang out with these two guys. 00:46:05:02 - 00:46:22:18 Unknown One of the perks for sure. Yeah, and also everyone, if you guys are listening in and you guys want to check out their websites, Articulate Labs tech so you can find more information on on the products. Everybody, this is the Hard Tech podcast. I'm your host DeAndre hierarchies with my ever so gracious co-host Grant Chapman. I'm just here because you love me. 00:46:22:20 - 00:46:27:00 Unknown Josh Herbie, thanks so much to be on the show. Thank you. Thank you. Yep. See you guys next week. 00:46:27:02 - 00:46:27:09 Unknown See you.