[HN Gopher] Launch HN: Flowly (YC S21) - Manage pain using VR an...
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Launch HN: Flowly (YC S21) - Manage pain using VR and biofeedback
Hey HN! This is Celine, Julien, and Narae of Flowly
(https://www.flowly.world/). Flowly is an app that combines VR and
biofeedback training to help people manage pain, reduce anxiety,
and increase relaxation (we send every member a VR headset and
Realtime HR Sensor to use). We started this company to serve the 1
in 3 Americans who suffer from chronic pain and we're now backed by
the NIH and National Institute of Drug Abuse. The opioid crisis
has exposed how prevalent chronic pain is and how inaccessible and
limited pain management solutions are today. Many pain management
tools don't address all aspects of pain because pain encompasses
more than physical pain: the top symptoms of chronic pain actually
include anxiety, depression, and feelings of social isolation. In
other words, chronic pain is a bio-psycho-social condition. It is
important to us that we address it as such and this comprehensive
approach is one of our core differentiators. I (Celine) started
the company because I grew up around pancreatic cancer patients,
who were experiencing excruciating pain. People close to me passed
away from morphine overdose and not even the cancer itself. I saw
how pain affected someone not just physically, but also
psychologically and socially. Later when I was developing
interactive content at DreamWorks, I got involved with VR and
biometric feedback for entertainment experiences. At a certain
point, I realized that all this cool tech had actually been studied
since the 80s for pain management. This resonated strongly with me
because of my personal experience. I brought in my best friend from
Yale, Julien, who was at Hyperloop One doing controls on their
Transponics team, and then Narae, an internationally recognized
designer and animator from Broadway and California Institute of the
Arts. Together we convinced the Chair of Anesthesiology at UCLA to
come aboard and design the Flowly prototype together. When we
developed Flowly we were adamant about two things: it has to be
accessible (needs to be easy to use at home) and it has to be
science-backed. Our NIH grant cites over 300+ studies using VR and
biofeedback for pain and anxiety management. We've conducted case
studies, Phase I clinical trials, and have more trials coming up.
Our Chief Principal Investigator is the Chair of Perioperative
Medicine at UPMC and our Director of Research is at USC. Another
aim we have is to make Flowly reimbursable (covered by insurance so
people who can't afford it can use it too)-- as you may know, that
is not an easy journey, but we are working on it. In the meantime,
we provide it direct-to-consumer for those who do have the ability
to pay for a subscription which is $30/month. We are acutely aware
this price point privileges certain populations to Flowly and
that's why we are working hard to get Flowly to be reimbursable. If
you have experience with this or have advice we would love all the
help we can get to make Flowly as accessible as possible. The
Flowly we've launched today works like this: you receive a kit with
your subscription that includes a mobile VR headset and real-time
Heart Rate Sensor that work with our iOS App. You enter a Flowly
session in VR which helps to tackle pain in a few ways. First, you
enter a beautiful immersive VR world that can work to distract you
from existing pain or anxiety (called Gate Control Theory). Second,
in each session you are guided to autoregulate and control your
nervous system, which is where much of the body's pain response is
modulated. You learn to control your nervous system through
biofeedback training which is the ability to see your realtime
biometric data (Heart Rate, Heart Rate Variability, respiration)
and then through calibrated breathing guides, voice-over, and light
gamification, we teach you how to control those metrics and shift
your body from fight-or-flight mode (your sympathetic nervous
system) to rest-and-recovery mode (your parasympathetic nervous
system). Third, we incorporate voice-overs in every session that
focus on different therapeutic approaches like Acceptance and
Commitment Therapy, Value Affirmation exercises, etc. Afterwards,
you can track your progress through a personalized data analytics
portal. You'll also get access to a text/call line with our Health
Coach for questions or help getting set-up. We're partnered with
University of Pittsburgh Medical Center, USC, US Pain Foundation,
and other institutions to provide Flowly to those who need it.
Surprisingly to us, this past year many people we didn't expect to
need Flowly also came to us for help-- folks like therapists who
needed anxiety management themselves, or families dealing with pain
and stress at home. We have a long way to go, but we feel
passionate about creating an opioid-sparing tool for pain
management. Check out our iOS app here:
https://apps.apple.com/us/app/flowly-relaxation-training/id1....
We're working on an Android version. We welcome your feedback,
questions and advice. Thank you for reading!
Author : tamadevr
Score : 38 points
Date : 2021-07-01 16:12 UTC (6 hours ago)
| yewenjie wrote:
| Another naive question : is this relevant for chronic back pain
| originating from bad posture?
| tamadevr wrote:
| For many people this is relevant for chronic back pain
| originating from bad posture. Our clinical studies actually
| focus on chronic back pain. But of course, everyone's case is
| unique so I would say it's worth a try, but I'd love to hear
| your feedback.
| dr_orpheus wrote:
| What is the timeline for the Android version of the app to be
| available? Is there a way I can sign up for a notification on the
| website when this comes available?
|
| I would be very interested in this for my father's chronic pain
| but he currently only has an Android device.
| tamadevr wrote:
| Definitely, if you shoot us an email (contact@flowly.world)
| expressing your interest in the Android version, we will add
| you to our waitlist for the Android Beta. We are aiming to get
| it out end of summer/beginning of fall. I hope we can be
| helpful for your father.
| marc__1 wrote:
| How to do compare your approach with the likes of Sana Health?
|
| Congrats for the launch!
| tamadevr wrote:
| Thank you. The difference lies primarily with our Virtual
| Reality component and our price points. Our sessions are
| interactive and through them you're learning tools and
| techniques to reduce pain, stress, and anxiety even outside of
| the sessions. We often hear our users tell us that they're able
| to implement what they've learned when they don't have the
| headset around. From our understanding, Sana is a device more
| meant to induce pain reduction when you use it and maybe for
| some residual effects after. They use light and sound
| stimulation to do that instead of a full virtual reality
| experience. Their price point is also significantly higher.
| awwx wrote:
| Pricing is hard to find; the main site only says "Join today for
| $29.99 to start." which could mean anything ("$30 for the first
| month and $300/month after that")
|
| I had to click through to the portal and then get past the kit to
| find the actual pricing. $30/month is quite reasonable if it
| works, and it'd be reassuring to see that up front!
| tamadevr wrote:
| Thank you for this feedback because we are still trying to work
| out how to best present information on our website. Do you
| think the pricing should come up earlier on the homepage?
| [deleted]
| KLR-motion wrote:
| Sounds amazing. I went through a minor stroke when I was 26 and i
| had a lot of symptoms induced by anxiety, indeed i was afraid to
| do another stroke and my anxiety produced similar sensations. Any
| time I had those symptoms coming I would play video games or
| whatch my metrics to reassure myself until it was gone. I think
| this tool would have been very helpful at the time. Thanks for
| trying to provide drug free solutions for people experiencing
| such problems!
| tamadevr wrote:
| Wow thank you for sharing your experience, and that's very
| intuitive and innovative of you to use video games to track
| your metrics. If you have any feedback for us please don't
| hesitate to reach out to me at celine@flowly.world
| orliesaurus wrote:
| A friend of mine does similar work on cerebral palsy patients -
| looks like more and more people are getting into VR-health for
| specific things! Pretty cool and good luck!
| tamadevr wrote:
| appreciate it and I can see how helpful VR could be for
| cerebral palsy patients.
| rckoepke wrote:
| How does the device measure respiration?
| tamadevr wrote:
| Right now we calculate something called Resonant Frequency
| Breathing Rate which is the unique breathing rate each person
| can breathe at to best optimize their Heart Rate Variability.
| We calculate this Breathing Rate through data derived from our
| Heart Rate sensor.
| runnerup wrote:
| I have to read into this answer a lot. Would it be accurate
| to say that the app calculates a "target" respiration rate,
| then provides visible or audible cues (e.g. a metronome) to
| tell the user exactly when to inhale/exhale? So the "actual"
| respiration isn't measured, but that isn't very important as
| it's quite trivial for a user to follow "inhale now", "exhale
| now" cues to the necessary degree of precision.
|
| Did I understand that correctly?
| tamadevr wrote:
| Yes that's essentially it. We calculate your target/ideal
| breathing rate and then have breathing guides during the
| session for you to follow. Then you're able to see your
| heart rate graph in realtime and understand how it changes
| with your breathing.
| davidajackson wrote:
| I am going to ask a very naive question but I want to understand.
| I likely have carpal tunnel. Watching Netflix or
| coding/technology videos are the few things I can do when in
| pain. For me I need distraction, is this geared more toward
| relaxation? Are the 2 interchangeable in a medical sense?
| tamadevr wrote:
| Not naive at all, distraction is definitely a recommended form
| of dealing with a lot of types of pain flare-ups. Our
| experiences are geared towards relaxation, but because our VR
| worlds are quite immersive, most of our members and study
| participants report they don't "think about [their] pain"
| during the session because they're focused on the experience
| and distracted from their flare-up. We also have some worlds
| that are more gamified such that you're actually playing a game
| in VR with a higher distraction element. Relaxation and
| distraction are not necessarily interchangeable but in VR they
| can often work together.
| Cyberdogs7 wrote:
| This is a very interesting concept. As an ex-game dev, I
| would very interested in the types of design sessions you go
| though and UX testing to high this perceived level of
| immersion in which people can be distracted from pain.
|
| Do you find this treatment only works for some people, or are
| the results more on a gradient of effectiveness?
| tamadevr wrote:
| Yes we went through a lot of testing in terms of design and
| UX to best optimize VR experiences for people with pain. In
| our designs we also have to be very cognizant of different
| triggers because we have a population of members who do
| have PTSD. Flowly can be helpful to quite a large spectrum
| of people but of course, as you say, it is a spectrum so
| effectiveness will vary for each individual.
| alex-wallish wrote:
| I also have severe carpal tunnel and am interested in how this
| might be able to impact that? Do you have any patients who have
| used this for that purpose?
| tamadevr wrote:
| We have had Flowly members who have carpal tunnel, however
| our clinical studies did not focus on carpal tunnel. I would
| say this might be worth a try to learn how to regulate your
| nervous system to better manage the stress and pain from
| carpal tunnel, but of course I'd love to hear your individual
| experience and feedback.
| tamadevr wrote:
| This didn't fit in with the above but dang said y'all might find
| this interesting:
|
| While developing VR experiences optimized for relaxation, we
| discovered different visual elements that most universally
| resonated across varying populations. We discovered horses
| resonated as an animal that represented comfort and relaxation
| with the majority of study participants who tried Flowly
| experiences. We had multiple participants who cried in relief
| after spending time with horses in our VR experiences. An
| unexpected discovery from all our testing.
| dharma1 wrote:
| Sounds very cool. Would it be possible to have a software only
| package (SteamVR and support for Apple/Android watch or similar
| sensors for heart rate/HRV) for those of us who already have
| the hardware (don't need the kit and are not in the US)?
| tamadevr wrote:
| We are hoping to provide software-only packages as well
| however at the moment, most wearables actually don't provide
| the realtime peak-to-peak heart rate interval data required
| to do the type of closed loop biofeedback we do. Once
| wearables are able to support this type of data we would love
| to provide Flowly software-only.
| disabled wrote:
| To do accurate and reliable HRV analysis you need a sensor
| (PPG/ECG/etc) that has a sampling rate of 500-1000 Hz
| minimum. This is especially the case for closed-loop. This
| is in order to do further calculations such as via
| respiratory sinus arrhythmia, to detect respiration rate.
|
| "More conservative guidelines advise between 500 and 1000
| Hz (Riniolo and Porges, 1997; Berntson et al., 2007), which
| may be particularly relevant in case of lower amplitude RSA
| (Riniolo and Porges, 1997)."
|
| See: https://www.frontiersin.org/articles/10.3389/fpsyg.201
| 7.0021...
|
| In terms of notable hardware you may want to look at this:
|
| https://plux.info/kits/511-bitalino-mini-solo-
| kit-810121033....
|
| Anyways, this series of boards (biosignalsplux) interfaces
| with Android/iOS/Unity/etc.
|
| Obviously Unity is for SteamVR or just Steam in general.
|
| The boards also have official support for the package
| LabStreamingLayer (there are also LSL interfaces for Unity
| on GitHub), which is extremely useful for the kind of work
| you are doing, with respect to calculations, processing,
| and analysis.
|
| I actually routinely work with physiological signals
| generated from the autonomic nervous system, and I do both
| processing and interfacing sides of this work. I also have
| an immune-mediated form of ANS failure, so I have personal
| relevant and translatable experience with respect to your
| project as a patient too.
|
| I hope this info helps!
| tamadevr wrote:
| Thank you for summarizing this so clearly and explaining
| why most wearables don't provide the data we need to do
| biofeedback training. Appreciate your insight here.
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(page generated 2021-07-01 23:00 UTC)