Ukrainian telemedicine firm ComeBack Mobility was established in 2020. The company was one of 14 startups included in the EMERGE list of the 100 most promising startup companies in the Central and Eastern Europe region. The company has designed a telemedicine device that attaches to the ends of walking crutches to assist patients in recovering from leg injuries.

Smart Crutch tips connect to a smartphone via Bluetooth, and the accompanying app can be downloaded to both Android and iOS devices. Based on weight-bearing parameters that the doctor sets, an alert is sent to both the patient and doctor’s phones if the leg is loaded incorrectly with too much or too little weight. The startup has raised $1 million in seed funding from medtech investment funds and Ukrainian angel investors.

ComeBack Mobility’s co-founder and CTO, bioengineering expert Lisa Voronkova, initially developed a product called EMWatch, a bracelet to monitor users’ stress levels. Developing this device and the difficulties encountered in the process taught her a great deal about the industry—specifically, creating technology for technology’s sake.

“We created a device that reads heart rate from the wrist and interprets how a person feels at that moment. It was high-standard technology, but we didn’t fully understand who needed it,” 27-year-old Voronkova told ZDNet in August. The product was successful, but didn’t receive the exposure Voronkova was hoping for.

Last year, health authorities approved telemedicine use for routine treatments in response to the COVID-19 pandemic. Voronkova co-founded ComeBack Mobility that year, the idea for Smart Crutch Tips inspired by her experiences in the field and patients’ experiences using crutches following leg injuries.

When walking on crutches, there’s a moment when the healthy leg is completely raised off the ground and the load is distributed between the crutches and the injured leg. Knowing the patient’s weight allows the doctor to pinpoint how much weight falls on the crutches, and subtract it from body weight to receive the amount of load that falls on the injured leg. According to the company, the error of weight sensors is less than 100 grams. The devices can be used for patients recovering from nonsurgical and surgical treatments for hip, thigh, knee, shin, ankle, and foot injuries and pathologies.

Also according to the company, patients tend to load their injured leg two times more than required. Eighty percent of patients are afraid to step on their feet after surgery, delaying timely rehabilitation. Patients also show difficulty replicating new weight bearing status restrictions. Adhering to optimal weight-bearing boosts recovery because mechanical loading enhances collagen maturation and tendon healing, prevents atrophy, and ensures glutamate upregulation and enhanced production of healing metabolite.

“We talked a lot to orthopedists to understand whether such a device was needed and if anything similar already existed—and if so, how it worked and whether it solved the problem, or not,” she said. “It turned out that it’s very much needed, but for the feet, not for the hands. It is difficult for patients to understand what it is like to load the leg by 20 percent or 50 percent, for example, and the wrong load leads to repeated health problems and additional surgery.”

One frequently asked question considers why the device is attached to crutches, and not a shoe. According to ComeBack Mobility testing, compared to insoles the crutch sensor ended up being more durable, with two years of successful use. It’s available to consumers of any age and shoe size, and was cheaper to implement. Also unlike insoles, after one patient has rehabilitated, the Smart Crutch Tips can be used by another patient.

To begin treatment using Smart Crutch Tips, a doctor sets a weight bearing program for the duration of the patient’s recovery. The patient then adheres to the weight bearing program using feedback cues from the crutch tips and app. The data is sent to the doctor’s phone and PC for analysis. The doctor monitors how the patient is loading the injured leg, addresses their concerns, and adapts the program to the patient’s needs as required. The patient finally adjusts the load on the injured leg according to their doctor’s instructions.

ComeBack Mobility can help doctors to empower the patient in their rehabilitation. They can set and control axial load, see the load for each step in real time, and identify causes of pain and swelling in the recovering leg. This helps to reduce risk of complications arising from premature or excessive axial load on the injured leg. Objective measures show the patient’s compliance to the doctor’s prescription, and patient anxiety can be decreased by addressing their rehabilitation concerns the moment they arise.

Ukraine is only the starting point. Voronkova said her startup has global ambitions.

“We started in Ukraine—the production was created here, our investors are also here—everyone is interested in us starting at home,” she said. “The U.S. market is the next stage for us, as there’s a bigger market, and the business can scale much faster. Naturally, there is also a global opportunity—leg injuries happen to hundreds of millions across the planet each year, and Smart Crutch Tips can help anyone heal faster and better.”

“There is an urgent need to support patients’ recovery outside of the clinic wall,” physical therapist Richard Hudson commented on ComeBack Mobility’s website. “We will now be able to send people home with instructions and instrumented exercise equipment that can actually measure and monitor what they are doing at home and, in some cases, adjust exercises as they go.”