Fine-tuning vibration therapy for cerebral palsy

In 2020 Andrew Lowry (Ngāruahine) attended an expo showcasing rehabilitation equipment for people with cerebral palsy. It was an experience that would change his life.

Lowry’s brother-in-law has cerebral palsy, a condition that affects the brain’s ability to control movement, balance and posture. Lowry knew the challenges cerebral palsy caused with everyday movements like walking.

“I remember leaving the rehabilitation exposition feeling underwhelmed and somewhat annoyed at how simplistic all the approaches were,” Lowry says. He decided if he was going to do a PhD, it would need to help people like his brother-in-law.

Six years later, on 23rd September, the newly minted Dr Andrew Lowry is proud to be one of the first Māori students to complete a PhD in bioengineering at Waipapa Taumata Rau, University of Auckland. Now his aim is to see if he can turn his research findings into real-world therapies.

A ‘curious’ upbringing

Lowry hails from Ngāruahine in Taranaki. But as a child, he moved around a lot. He was born in Cyprus and spent his early years outside Athens. Moving to Hamilton as a teenager was tough, he says. “Calling it a shock to the system would be putting it mildly.”

But travel, and being the youngest of four, had kept the young Andrew curious and open-minded. Growing up with an engineer father was also an influence. Andrew was building and fixing things around the house from a young age; Lego and Meccano were among his favourite toys.

“While engineering was kind of an unconscious choice, the only question was what type,” Lowry says. He enjoyed physics at school, but it was his love of biology and interest in human health that pointed him toward a masters in biomedical engineering - and eventually a PhD.

“I’ve always enjoyed problem solving and trying to understand the ‘why’ behind things”. That curiosity, paired with his experience at that rehabilitation expo, shaped the direction his PhD would take.

Lowry chose to focus on vibration therapy, working with the University of Auckland’s Bioengineering Institute (ABI).

Vibration therapy has been used to help with injury and chronic muscle-related conditions for hundreds of years; more recently the technology has evolved as a way to temporarily reduce muscle stiffness (the technical term is ‘muscle spasticity’) and improve mobility in people who have cerebral palsy, have suffered a stroke or who have other conditions.

People sit, kneel, stand or lie on a vibrating platform, which sends energy through their body, causing muscles to rapidly contract and relax.

Lowry says it’s hard to find consensus on the best way to deliver the treatment.

“Vibration therapy was already a tool being used to support my brother-in-law, but why and how it was being applied didn't seem to fit any rhyme or reason. My PhD investigated how the vibration can be tweaked to best alleviate the muscular symptoms of cerebral palsy”. 

A big part of the research involved Lowry designing and building a customised vibration device which allowed the amplitude and frequency of the vibrations to be controlled independently. He studied how different settings, including vibration speed and size, affected the body’s reflexes, specifically the overactive nerve signals in the spine that cause muscle spasticity.

He found that it was the size of the vibration that mattered most, though only up to a certain point. There is more work to be done, he says.

“The goal – after future iterations - is for the knowledge gained from the device to be used therapeutically to better inform how vibration therapy is applied, ultimately improving the lives of people living with muscle spasticity.”  

It hasn’t always been an easy road. Lowry is the first to admit the heavy writing load of his PhD wasn’t his favourite part. Nor was the bottomless pile of literature he had to read.

His real enjoyment came from the hands-on design of his research device, and from experimenting with it.

“Taking my drawings off the screen and seeing them physically in place performing as desired was easily the biggest highlight.”

That feeling carried through to the lab, where running a successful experiment after many failed ones was another highpoint.

It was also a turning point for his supervisor, Professor Justin Fernandez.

“I’ll always remember the day Andrew and I were testing out muscle vibration in the University’s Newmarket gait lab when we had a eureka moment and got the early results we were hoping for.”

As Lowry explains: “A critical part of the experiment was electrically triggering and then measuring a reflex response in the body called the H-reflex. Getting to the point where we were able to reliably acquire this H-reflex was particularly difficult and time consuming.

“However, once we’d figured this out, our hope was that in applying vibration to the muscle, we could dampen or reduce this reflex, and this is exactly what happened. While applying vibration to the muscle, the H-reflex basically went away.”  

Collegial support

Lowry says having the support of other postgrad students at the ABI was critical to him being able to finish his PhD.

“I think doing a PhD is a somewhat unique experience which can only really be comprehended by others going or who have gone through it,” he says.

Seeing colleagues face the same challenges and push through gave him the resolve to keep going. That and “copious chocolate consumed”, much to the despair of his GP.

The chance to travel to conferences, including a trip to Japan, was another thing that kept him motivated through the harder stretches. 

Beyond the lab

With his PhD complete, Lowry’s goal is a career in medtech, the sector focussing on creating medical devices, equipment and digital health technologies to improve patient care.

As part of that he wants to take his vibration therapy research work beyond the lab, moving it from promising findings to something that could genuinely help people. To get there, he’s hoping to partner with Medtech-IQ, a national innovation hub based at the University of Auckland that helps researchers turn discoveries into usable medical technologies.

Fernandez says Lowry was always interested in gait analysis technology and experimental biomechanics, but he also had a passion for entrepreneurial opportunities and commercialisation.

Still, Lowry knows nothing happens fast in bioengineering research.

“Doing a PhD has shown me that research moves forward in small, iterative steps, and I’ve been lucky enough to take us one step further. If that step means people living with spasticity have to struggle just a little less, then it’s been worth it. 
 

Article written by Sally Hamilton