As CTO and Co-Founder of CedrTech, our mission is to develop robust hardware and software solutions that address complex real-world challenges. Our work with Comeback Mobility represents a pinnacle of this effort, showcasing how a comprehensive, interconnected technology stack can revolutionize patient care in the rapidly evolving MedTech landscape.
The Challenge of Compliance in Post-Op Recovery
For patients recovering from severe leg injuries or orthopedic surgery, the rehabilitation phase is often the most critical–and the most unpredictable. Doctors prescribe specific, non-negotiable weight-bearing protocols to ensure proper bone healing, but in the chaotic, uncontrolled home environment, adherence is notoriously low. The common instruction, “weight-bearing as tolerated,” is often insufficient and, as clinical evidence shows, can lead to complications, reoperations, and a significantly slower recovery.
Comeback Mobility recognized that the key to better outcomes wasn’t just what the patient was told, but how they were monitored and guided.
The Comeback Mobility Solution: Precision Biofeedback and SaaS
Comeback Mobility has developed an end-to-end medical IoT platform centered around Smart Crutch Tips. These tips are equipped with high-precision sensors that measure real-time axial load, effectively turning a simple mobility aid into a sophisticated diagnostic and feedback tool.
The system works by establishing a fully personalized protocol. Physicians use advanced analytical tools–sometimes based on post-operative CT scans and Finite Element Modeling–to calculate the exact, optimal weight-bearing load needed for the specific injury. This personalized prescription is then delivered via a secure mobile app.
As the patient walks, the smart tips provide instant, non-intrusive biofeedback (usually auditory or haptic) if they exceed the prescribed load. This real-time guidance ensures the patient stays within the safe zone, empowering them to manage their own recovery while adhering perfectly to the medical protocol. Simultaneously, the system streams advanced step metrics and compliance data back to the healthcare provider, allowing for critical remote monitoring and intervention when necessary.
Fun Fact: The Compliance Revolution
In traditional post-operative care, adherence to weight-bearing protocols can be shockingly low. However, clinical studies on the Comeback Mobility system have demonstrated a massive leap in patient success: users receiving biofeedback guidance achieved a 73.60% adherence rate compared to just 21.10% in control groups. This dramatic, measurable improvement proves the power of combining IoT and biofeedback in MedTech.
The CedrTech Approach: A Robust Tech Stack for Medical Reliability
Building a platform that handles real-time sensor data, requires FDA clearance, and manages sensitive patient information demands an extremely robust, secure, and scalable tech stack. Our development experience focused on creating a seamless, compliant data pipeline from the tip of the crutch to the clinician’s dashboard.
Here is an overview of the technical architecture driving Comeback Mobility:
The IoT Core: Hardware & Embedded Systems
The foundation of the entire platform is the smart crutch tip itself.
- Microcontrollers: Utilizing reliable, low-power STM32/ESP32 microcontrollers ensures the sensor data is collected accurately and efficiently.
- Programming: The embedded software is written in C/C++ (RTOS), prioritizing speed and real-time responsiveness essential for immediate biofeedback.
- Connectivity: BLE (Bluetooth Low Energy) provides the secure, low-latency communication link between the device and the patient’s mobile app.
- Updates: A custom OTA (Over-The-Air) system allows for secure, remote firmware updates, minimizing the need for device returns.
The Patient Interface: Mobile Applications
The mobile apps are the patient’s primary coach and the data collection hub.
- Platforms: Native development is prioritized for performance and reliability, using Kotlin (Android) and Swift/SwiftUI (iOS).
- Data Exchange: Bluetooth communication uses platform-specific libraries (Nordic/CoreBluetooth) to ensure consistent data ingestion.
- User Management: Firebase provides robust tools for patient authentication and ancillary data management.
The Engine Room: Backend Services
The backend is built to handle high-throughput sensor data and complex medical logic.
- Core Logic: NestJS (TypeScript) provides a scalable, enterprise-grade framework for managing user authentication and core business logic via modern REST/GraphQL APIs.
- Relational Data: PostgreSQL handles standard user, protocol, and configuration data.
- Time Series Data: For high-frequency, sequential sensor readings, specialized time-series databases like TimescaleDB/InfluxDB are employed to efficiently store and query patient step-by-step load data.
- Messaging & Caching: Redis is used for high-speed caching, while RabbitMQ/Kafka ensure reliable, asynchronous messaging for data ingestion and processing, minimizing latency.
The Doctor’s View: Frontend and Analytics
Clinicians require powerful, intuitive dashboards to analyze patient progress remotely.
- Framework: The web application is built with React + Next.js for server-side rendering, ensuring fast load times and a highly responsive user experience.
- Styling: Tailwind CSS enables rapid, utility-first UI development.
- Data Visualization: Recharts is used for dynamic, clear visualization of complex step metrics, compliance percentages, and weight-bearing history.
The Infrastructure Backbone: Scalability & Reliability
- Cloud Providers: Leveraging AWS/GCP provides the scalability needed for a rapidly growing SaaS platform.
- Deployment: Docker containers and orchestration via Kubernetes/ECS ensure infrastructure stability, portability, and efficient resource utilization.
- CI/CD: GitHub Actions automates the testing, building, and deployment process, maintaining a rapid and reliable development cycle.
Security, Compliance, and Data Integrity
In MedTech, security is paramount.
- Security Tools: Data is protected with industry-standard TLS/AES-256 encryption, while audit logs track all data access. SSO/Keycloak handles secure single sign-on for enterprise clients.
Observability & Insights
Understanding system performance and user behavior is* critical for continuous improvement.
- Monitoring: Prometheus and Grafana provide infrastructure and application performance monitoring.
- Logging: The ELK/OpenSearch stack handles robust centralized logging.
- Behavioral Analytics: PostHog offers fine-grained insights into product usage and patient engagement.
Clinical Validation: Putting Precision to the Test
To ensure the Smart Crutch Tips meet the highest standards of efficacy and safety, Comeback Mobility is actively engaged in rigorous clinical research. These trials are essential for demonstrating superior patient outcomes compared to standard care, focusing on specific and common lower extremity fractures:
1. Smart Crutch Tips for Guided Weight-Bearing in Patients Recovering From Tibial Shaft Fractures
- NCT Number: NCT07092579
- Focus: Evaluating the benefit of guided weight-bearing in healing and recovery following fractures in the main bone of the lower leg (tibia).
2. Smart Crutch Tips for Guided Weight-Bearing in Patients Recovering From Extra-Articular Proximal Tibia Fractures
- NCT Number: NCT07134257
- Focus: Assessing outcomes when the biofeedback system is used for fractures near the knee joint that do not involve the joint surface.
3. Smart Crutch Tips for Guided Weight-Bearing in Patients Recovering From Extra-Articular Distal Tibia Fractures
- NCT Number: NCT07138066
- Focus: Determining the efficacy of controlled loading protocols for fractures near the ankle joint that do not involve the joint surface.
Media Spotlight: Expanding the Conversation
The innovative approach of Comeback Mobility to rehabilitation has naturally garnered attention from media outlets covering technology and healthcare innovation. This recognition validates the critical role that advanced hardware and software play in delivering measurable patient outcomes:
- MC Today: “Розумні насадки на милиці та інвестиції в науку: як Comeback Mobility змінює підходи до реабілітації” (Smart crutch tips and investment in science: how Comeback Mobility is changing approaches to rehabilitation) – Read the Article
- Scroll Media: “Comeback Mobility Research” – Read the Article
Conclusion
The Comeback Mobility platform demonstrates how a carefully chosen, high-performance technology stack can solve one of healthcare’s most persistent problems: patient compliance at home. By merging IoT hardware, personalized medicine protocols, and enterprise-grade infrastructure, CedrTech has helped deliver a solution that not only enhances bone healing and prevents complications but also provides significant data for physicians—fundamentally shifting the paradigm of musculoskeletal rehabilitation from passive instruction to active, guided recovery.
