“Rehab Athletes Like Athletes” (And Prove It With Data)

WEBVTT

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But that's the idea.

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All right, appreciate you, The Voice Guy.

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I want to say thanks to Empower EMR.

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If your clinic's stuck on an EMR that

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slows you down, Empower gives you speed,

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clean workflows,

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and features PTs actually ask for.

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Better notes, faster documentation,

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smoother operations,

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all wrapped up in customer support that

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doesn't ghost you.

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Upgrade your clinic's brain,

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that's what EMR really is, right?

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With Empower EMR, that's empoweremr.com,

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empoweremr.com.

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Today we're asking hard questions.

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Why are physical therapists,

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the supposed experts in human movement,

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still describing biomechanics like it's...

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It's a great year,

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but it's still a long time ago.

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Here,

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while AI is quantifying everything...

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While trainers are capturing slow motion

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video, while patients are expecting data,

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most PTs are still writing knee valgus

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noted at sixty degrees.

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Our guests today believe that if we want

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to defend our space in musculoskeletal

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care,

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we need to measure what we claim to

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master.

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Today,

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they're representing one of the most

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interesting tools in movement assessment

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right now.

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Let's bring our guests today,

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Maka and Dan.

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Welcome to the show.

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Thank you.

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Good to see you, Jimmy.

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How was the intro?

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Did I sort of capture like the goal

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of what we want to talk about today?

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Like,

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was I close or I'm just a podcast

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host.

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What do you think, Maka?

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Nailed it.

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All right.

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So let's start with this.

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What changed about the way movement is

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valued in our profession?

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Let me rephrase this.

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How it's valued just not in our

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profession,

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but even outside our profession and with

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our patients and with the people that we

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interact with,

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other professionals or sometimes the dirty

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word, payers.

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What's changed about the way movement is

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valued?

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Well, I'll start off.

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I don't know that anything has changed so

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much,

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but I think there's a very deep interest

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in understanding biomechanics,

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and a lot of people

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attest to understanding biomechanics and

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talk about it a lot,

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but can't really quantify it.

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And I think sort of like made up

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terms for describing some of the things

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that they see.

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And of course, it's like,

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it's very challenging.

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I've been a PT for three years.

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And it's still,

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it's still very challenging to notice

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biomechanical faults or defects or

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asymmetries with the naked eye.

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And then how to describe them, right?

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Like how would you do,

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like describing them from one clinician to

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another is probably vastly different.

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Macca, how would you answer that question?

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How have things sort of changed?

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I think the competition has changed,

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honestly.

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So from PT to PT.

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So parents sending their kids in,

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you're trying to figure out which clinic

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you'd like to go to.

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So I think who's going to assess the

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mechanics correctly,

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who's going to assess it differently.

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So I think that's the biggest thing that's

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changed.

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I think we know that valgus is bad.

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Too much valgus is bad.

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But I think we need to understand, like,

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how do you know if it's too much

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valgus?

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So I think it's changed.

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I just know I was just feeling right

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in a profession where it's not the

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profession where we'd never,

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that would never be okay somewhere else.

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So let's call this out.

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Are,

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are physical therapists too comfortable

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just sort of eyeballing biomechanics?

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I think some are comfortable.

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I think some are really busy too.

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I'll add to that, that, um,

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some are very comfortable with it.

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Um,

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I've been a PT for thirty years.

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And by the way,

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I don't know that I'm always accurate.

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Right.

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But I am comfortable with it.

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I think I know what I'm talking about

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when I see a patient with excessive valgus

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or whatever it may be.

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But I also think that less experienced PTs

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are not very comfortable with it and kind

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of feel like they're guessing a lot.

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Right.

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And so what do we do?

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The question is, like,

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what do we do about it?

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So when we add quantifiable data

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to movement, what changes?

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What changes clinically?

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What changes?

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I'll stop there.

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What changes when you can actually

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quantify it?

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I think your rapport with the patient

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changes, definitely.

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So being able to explain to them,

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this is too much valgus,

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show them too much valgus,

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speed of valgus.

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I think your direction of how you're

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rehabbing someone changes too in what

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phase.

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So is it too much valgus during the

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loading?

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Is it too much valgus during the landing?

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That's definitely going to change the way

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that I'm doing some rehab.

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I'm an athletic trainer.

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I'm not a physical therapist.

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I've worked with various ranges of

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population,

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but I think that's what changes a lot.

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Um, Jimmy, what was your question again?

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Sorry.

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Yeah.

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So, so sort of like what,

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what changes clinically when we can

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actually add quantifiable data,

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like when we can actually say,

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this is the number and I can do

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it and I can get to that number

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reliably and confidently.

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Totally.

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Well, I agree with what Maka said.

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In addition, first of all,

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educating patients is huge.

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I mean, when you can show patients,

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this is what's normal and this is what

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you're doing.

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Now we have goals and objectives for them

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to, you know,

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targets for them to get to,

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but also documentation for standardization

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of documentation, right?

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We're all using the same tools to measure

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things as opposed to our own

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Different set of eyes and documentation

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for insurance companies being able to

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prove that a patient needs more therapy or

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has achieved their goals,

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whatever it may be.

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Quantifying.

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Yeah,

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I was going to guess things like patient

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buy-in, which was mentioned,

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better documentation mentioned,

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better communication with other healthcare

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professionals,

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with PTs to athletic trainers or to MDs

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or to insurance companies.

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And also,

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I would imagine better outcomes tracking,

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like changing over time.

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I remember when I was in clinic,

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measuring one thing on the same person,

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twenty minutes later, felt different.

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Yeah,

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you open up your joint a little bit.

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You activate some muscles a little bit.

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It may change quite a bit.

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I think the,

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so you talk about the relationship or like

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the communication from, you know,

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the athletic trainer to the PT,

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the PT to the surgeon,

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that having substantial objective data is

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so helpful with that communication because

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it's not just like my eye looking at

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this.

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It's like factually,

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this is where this person is in their

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state of rehab.

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I think sports medicine is

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return to play.

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So I will always communicate to the

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strength and conditioning coach,

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the athletic trainer, the PT, the surgeon,

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and then the parent too.

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So it holds that,

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it holds the clinician accountable,

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the athlete accountable,

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and then gen pop patients accountable as

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well.

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Yeah,

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I remember I was a swim coach for

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kids when I was in PT school and

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I was using like phone apps, right?

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That would allow me to put like sort

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of like a rudimentary goniometer on the

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screen quickly, easily.

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And when, you know, teaching a kid like,

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I need you to bend your elbow.

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I am.

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And me to say like, okay,

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look at your brother and let me show

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you this angle and yours is this and

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that number is larger than that one.

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I need you to give me a bigger

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number and I could show them side by

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side.

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That changed understanding,

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which is simple but not easy.

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And the competitive nature to you're like,

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OK, yeah, elbow a little bit further,

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a little bit more drive,

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a little bit more awareness.

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So a real specific use case that we

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have is we call the AMI,

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which was developed by physical therapist

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Trent Nestler.

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Michael,

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you want to talk about it a little

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bit?

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Yeah, so our athletic movement index,

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it uses four IMU sensors.

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So there's two sensors that go on the

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back and then two sensors that go on

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the shin.

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And it's a standardized test.

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So Trent's dedicated most of his

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profession to understanding why do ACLs

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happen?

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How do we rehab athletes back like

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athletes?

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And then how do we communicate them back

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to the surgeons or whoever needs to know

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this data?

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And so our sensors are placed on the

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body.

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And it doesn't matter if I like you

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as a kid or if I like you

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as a patient, you're working hard.

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the sensors are going to pick up the

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actual data.

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So we have them go through a series

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of movements like planks,

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double leg squats, single leg movements,

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single leg hop.

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And just the idea of it is to

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standardize the approach and to take all

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of that subjectivity out of it so we

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can truly do objective data,

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truly make our return to play decisions or

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return to work or return to real life

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decisions with actual data.

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So it's been really helpful.

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There's with our system,

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there's sensors that are placed on the

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body,

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but you also have a video feedback as

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well.

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So that visual interpretation,

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that's helpful for the patients.

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And then you're gaining the rapport from

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them too.

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All right.

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So Mac is already like your telegraph and

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you're tipping off my next question,

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which was going to be if a clinic

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owner or a clinician is listening right

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now thinking that sounds cool.

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But man, I've been sold this before,

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right?

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Like, do I need another gadget?

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What would you say?

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Is it it's got to be simple.

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It's got to be easy.

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It's got to be quick.

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If it's not those things.

00:09:25.264 --> 00:09:25.945
It's hard to use.

00:09:26.004 --> 00:09:28.106
So talk to me about what the actual

00:09:28.366 --> 00:09:29.427
tech looks like and how it works.

00:09:30.767 --> 00:09:31.947
Well, I can show you right here.

00:09:32.028 --> 00:09:33.748
So here's the IMU sensors.

00:09:33.888 --> 00:09:35.107
It's just you don't have the sticker on

00:09:35.128 --> 00:09:35.408
them.

00:09:35.869 --> 00:09:36.688
So it's an iPad.

00:09:36.708 --> 00:09:37.889
So it's an app that goes on to

00:09:37.908 --> 00:09:38.649
your iPad.

00:09:38.688 --> 00:09:39.429
It's called vMove+.

00:09:40.470 --> 00:09:42.149
We have two types of technology.

00:09:42.169 --> 00:09:43.750
So if you're looking for that quick

00:09:43.910 --> 00:09:45.431
assessment in the clinic,

00:09:45.951 --> 00:09:47.272
I don't want to put anything on the

00:09:47.312 --> 00:09:48.672
body, we have video AI.

00:09:48.851 --> 00:09:51.113
So you basically open up the application,

00:09:51.153 --> 00:09:51.852
start filming.

00:09:52.033 --> 00:09:53.673
Our system will place an algorithm over

00:09:53.734 --> 00:09:54.494
top of the body.

00:09:54.894 --> 00:09:56.754
We always blur out the face as well

00:09:56.793 --> 00:09:58.154
to keep it HIPAA compliant.

00:09:58.855 --> 00:10:00.756
And you can have them do any type

00:10:00.797 --> 00:10:01.918
of movement that you want.

00:10:01.998 --> 00:10:03.340
You can have them do a box drop,

00:10:03.399 --> 00:10:04.421
lateral bounds.

00:10:04.961 --> 00:10:06.822
I just did a mass testing with baseball

00:10:06.842 --> 00:10:07.344
pitchers.

00:10:07.904 --> 00:10:09.505
And what our system will do is it'll

00:10:09.546 --> 00:10:11.447
calculate the joint angles.

00:10:11.548 --> 00:10:12.970
For example,

00:10:13.049 --> 00:10:14.812
we have a module that's called lower limb

00:10:15.272 --> 00:10:17.053
and we look at the anterior view,

00:10:17.214 --> 00:10:18.235
auto detects the view.

00:10:19.115 --> 00:10:20.216
Anterior view is going to look at the

00:10:20.256 --> 00:10:23.599
pelvis, pelvic drop, pelvic hip hike,

00:10:23.639 --> 00:10:24.198
Trendelenburg,

00:10:24.519 --> 00:10:26.581
whatever you're looking for there.

00:10:26.821 --> 00:10:28.581
And then valgus and then tibia to surface.

00:10:29.322 --> 00:10:31.102
If you have the person face laterally,

00:10:31.182 --> 00:10:32.744
then it'll pick up the lateral view.

00:10:32.764 --> 00:10:34.684
So now we're detecting trunk lean,

00:10:35.265 --> 00:10:36.486
hip flexion, knee flexion,

00:10:36.567 --> 00:10:37.547
ankle dorsiflexion.

00:10:38.087 --> 00:10:38.908
So you have the,

00:10:39.427 --> 00:10:41.690
I'll just give a pretty good example.

00:10:41.710 --> 00:10:43.530
I think that everyone has used before.

00:10:44.130 --> 00:10:46.032
um surgeons in this area still will do

00:10:46.111 --> 00:10:47.773
triple hop tests so we're looking at

00:10:47.974 --> 00:10:50.195
distance and speed for triple hop tests

00:10:50.215 --> 00:10:52.275
and symmetry but you're missing out on the

00:10:52.336 --> 00:10:54.878
kinematic integrity so if you want that

00:10:54.918 --> 00:10:56.678
kinematic integrity you want to build up

00:10:56.698 --> 00:10:58.440
the relationship with the doc you want to

00:10:58.500 --> 00:11:01.181
get the great you know assessments and the

00:11:01.221 --> 00:11:03.383
objective data you can have them go

00:11:03.423 --> 00:11:04.803
through the triple hop test but then

00:11:04.823 --> 00:11:06.524
you're just filming them and getting the

00:11:06.684 --> 00:11:08.765
actual objective data our system will give

00:11:08.806 --> 00:11:10.826
you the target values and what you should

00:11:10.866 --> 00:11:11.307
be hitting

00:11:12.148 --> 00:11:13.349
So there's that realm.

00:11:13.469 --> 00:11:14.609
It's a five second clip.

00:11:14.668 --> 00:11:15.870
You open up the app and you just

00:11:15.889 --> 00:11:16.429
start filming.

00:11:17.210 --> 00:11:19.211
Then you have the IMU sensors that I

00:11:19.230 --> 00:11:19.931
just showed you.

00:11:20.171 --> 00:11:23.273
That's going to be like our gold standard.

00:11:23.373 --> 00:11:25.793
So we validate everything against Vicon.

00:11:25.854 --> 00:11:28.514
It's within one to two degrees of Vicon.

00:11:29.014 --> 00:11:30.375
You place the sensors on the body.

00:11:30.655 --> 00:11:31.676
I would say this is going to be

00:11:31.716 --> 00:11:33.876
your go to for like return to play

00:11:33.917 --> 00:11:34.418
testing.

00:11:37.184 --> 00:11:39.466
It's a tool in your kit, right?

00:11:39.525 --> 00:11:40.687
Like I would say,

00:11:41.006 --> 00:11:41.908
I still want to know,

00:11:42.087 --> 00:11:43.349
I'm thinking sports medicine.

00:11:43.969 --> 00:11:45.509
So I still want to know what do

00:11:45.529 --> 00:11:46.629
they look like on the field?

00:11:46.691 --> 00:11:47.091
What are they,

00:11:47.311 --> 00:11:48.871
what does their conditioning look like?

00:11:49.172 --> 00:11:50.812
Surgeon, what does the graph look like?

00:11:51.493 --> 00:11:53.754
But with the tech, the sensors,

00:11:53.794 --> 00:11:55.395
you place them on the body and it's

00:11:55.436 --> 00:11:57.116
capturing that data for you.

00:11:57.157 --> 00:11:58.697
And it's looking at valgus,

00:11:58.716 --> 00:12:00.437
speed of valgus, tibial inclination,

00:12:00.519 --> 00:12:03.059
pelvic anterior tilt, right?

00:12:03.279 --> 00:12:04.900
So that's some interesting information.

00:12:05.101 --> 00:12:06.162
Time to stability.

00:12:06.562 --> 00:12:08.303
So it's putting together a whole like

00:12:09.184 --> 00:12:11.626
really good case of this is why they

00:12:11.647 --> 00:12:13.008
should return to back to play or this

00:12:13.048 --> 00:12:14.528
is why they shouldn't go back to play.

00:12:15.870 --> 00:12:16.129
And again,

00:12:16.149 --> 00:12:17.552
it's taking that subjectivity out.

00:12:17.731 --> 00:12:18.773
But it's a quick assessment.

00:12:18.793 --> 00:12:21.134
It's about fifteen minutes for a full AMI

00:12:21.153 --> 00:12:22.956
screen or you can break it down into

00:12:23.035 --> 00:12:24.537
some single leg movements.

00:12:24.917 --> 00:12:26.298
And that takes about three minutes.

00:12:26.839 --> 00:12:28.759
So super quick, super easy.

00:12:28.860 --> 00:12:29.201
And like,

00:12:29.301 --> 00:12:31.283
why wouldn't you be doing some objective

00:12:31.322 --> 00:12:31.702
testing?

00:12:32.096 --> 00:12:34.740
And then what is just some of the

00:12:34.799 --> 00:12:37.104
dashboard of the data look like?

00:12:37.124 --> 00:12:38.567
What are you getting in actionable

00:12:38.647 --> 00:12:39.207
information?

00:12:40.235 --> 00:12:42.035
Yeah, so you're getting for the AMI,

00:12:42.056 --> 00:12:45.197
for example, we're putting it on.

00:12:45.356 --> 00:12:46.736
So when you're actually doing the

00:12:46.756 --> 00:12:48.736
assessment, it's live data tracings.

00:12:49.118 --> 00:12:50.778
So you're seeing it live on the screen,

00:12:50.878 --> 00:12:52.437
how much they're going into tibial

00:12:52.457 --> 00:12:53.118
inclination.

00:12:53.677 --> 00:12:54.957
And then when you're finished with the

00:12:54.998 --> 00:12:55.479
assessment,

00:12:55.499 --> 00:12:56.999
there's an auto-generated report.

00:12:57.298 --> 00:12:59.619
And so what we'll give you is red,

00:12:59.658 --> 00:13:00.339
yellow, green.

00:13:00.379 --> 00:13:01.639
This is where you're scoring on these

00:13:01.679 --> 00:13:02.600
specific movements.

00:13:02.639 --> 00:13:05.519
We'll give you target key takeaways.

00:13:05.559 --> 00:13:06.961
This is where you should look.

00:13:07.421 --> 00:13:09.301
If you're going into a single leg hop,

00:13:09.980 --> 00:13:12.081
and you're going into too much valgus and

00:13:12.121 --> 00:13:13.621
your hip is going all over the place,

00:13:13.842 --> 00:13:16.182
our key takeaways may sound something like

00:13:16.322 --> 00:13:17.783
lack of neuromuscular control,

00:13:17.864 --> 00:13:19.164
lateral hip weakness.

00:13:19.345 --> 00:13:21.565
So it's giving the clinicians,

00:13:22.826 --> 00:13:24.285
where do you need to look and how

00:13:24.326 --> 00:13:25.647
do you need to work with this patient?

00:13:25.667 --> 00:13:26.947
So it's saving you time with that

00:13:27.027 --> 00:13:28.148
auto-generated report.

00:13:28.327 --> 00:13:29.548
And then you can just drop it into

00:13:29.567 --> 00:13:31.849
your EMR and bill nine, seven, seven,

00:13:31.869 --> 00:13:32.450
five, zero.

00:13:32.570 --> 00:13:32.789
And that's,

00:13:33.110 --> 00:13:34.250
you don't have to do any additional

00:13:34.269 --> 00:13:35.130
information on that.

00:13:35.530 --> 00:13:36.130
It's all right there.

00:13:36.792 --> 00:13:38.793
So we're currently not integrated with any

00:13:38.913 --> 00:13:39.352
EMRs,

00:13:39.432 --> 00:13:40.773
but that is something that we're

00:13:40.812 --> 00:13:41.393
interested in.

00:13:41.793 --> 00:13:43.333
Um, that would be, I mean,

00:13:43.653 --> 00:13:44.813
extremely valuable for that to

00:13:44.933 --> 00:13:45.714
auto-populate.

00:13:46.673 --> 00:13:50.355
So right now it sounds like a simple

00:13:50.394 --> 00:13:52.735
copy paste into the appropriate section of

00:13:52.755 --> 00:13:53.316
the EMR.

00:13:53.975 --> 00:13:55.797
And that's our, that's our AMI.

00:13:55.836 --> 00:13:57.596
We also have a run assessment too,

00:13:57.616 --> 00:13:58.937
which is so cool.

00:13:58.996 --> 00:14:01.018
No one's doing the stuff that we're doing.

00:14:01.475 --> 00:14:03.096
It's like ground reaction force during

00:14:03.135 --> 00:14:03.615
mid-stance,

00:14:03.655 --> 00:14:05.256
initial peak acceleration during foot

00:14:05.317 --> 00:14:05.616
strike,

00:14:05.636 --> 00:14:07.437
which we know is directly correlated with

00:14:07.456 --> 00:14:08.797
stress fractures, shin splints.

00:14:09.298 --> 00:14:10.977
And then you also get a video AI

00:14:11.018 --> 00:14:11.498
component.

00:14:11.538 --> 00:14:13.378
So we're putting the force data together

00:14:13.457 --> 00:14:15.158
plus the video capability.

00:14:15.219 --> 00:14:16.938
So you can map out like, okay,

00:14:16.979 --> 00:14:18.078
during initial contact,

00:14:18.139 --> 00:14:19.539
this is what your IPA is.

00:14:20.019 --> 00:14:21.240
And this is what your hip flexion and

00:14:21.320 --> 00:14:23.659
ankle dorsiflexion is or your knee

00:14:23.679 --> 00:14:24.201
flexion.

00:14:24.421 --> 00:14:25.841
So you're putting together a nice story

00:14:25.880 --> 00:14:26.500
for that patient.

00:14:27.278 --> 00:14:27.778
Understood.

00:14:28.379 --> 00:14:30.000
So is this a this feels like it

00:14:30.039 --> 00:14:32.542
could be a shortcut or a multiplier?

00:14:33.302 --> 00:14:33.902
Or both?

00:14:34.423 --> 00:14:35.082
Yeah,

00:14:35.562 --> 00:14:38.504
test healthy people test patients in

00:14:38.565 --> 00:14:40.885
clinic, check your progress, Jake,

00:14:41.285 --> 00:14:42.907
test them when they're ready to be

00:14:42.947 --> 00:14:43.386
released.

00:14:45.184 --> 00:14:45.504
For sure.

00:14:45.585 --> 00:14:47.427
And the shortcut is it's fast.

00:14:47.506 --> 00:14:49.948
I mean, video AI, five seconds,

00:14:49.989 --> 00:14:51.931
basically have someone do one or two

00:14:51.971 --> 00:14:54.832
squats and you can get so much data

00:14:54.852 --> 00:14:55.432
and information.

00:14:55.774 --> 00:14:56.815
And obviously you can have them do

00:14:56.855 --> 00:14:58.015
multiple reps and compare,

00:14:59.035 --> 00:15:00.857
particularly as you give them verbal cues,

00:15:00.937 --> 00:15:01.557
corrections,

00:15:02.198 --> 00:15:03.960
and show them how they're improving

00:15:04.000 --> 00:15:05.922
throughout a session as you told them to

00:15:06.241 --> 00:15:07.722
maybe shift their weight to the right as

00:15:07.744 --> 00:15:09.225
they get a little bit lower.

00:15:10.423 --> 00:15:10.964
Things like that,

00:15:11.083 --> 00:15:12.504
or correcting their running.

00:15:13.264 --> 00:15:15.147
But like you said, a multiplier,

00:15:15.567 --> 00:15:18.408
the amount of information and the quality

00:15:18.688 --> 00:15:21.270
of data that we get with the sensors

00:15:21.431 --> 00:15:24.212
is incomparable in clinical.

00:15:25.234 --> 00:15:26.134
in clinic.

00:15:26.173 --> 00:15:26.793
So, you know,

00:15:27.195 --> 00:15:29.215
to get that sort of that level of

00:15:29.254 --> 00:15:31.716
data anywhere else, I think it's Vicon,

00:15:31.796 --> 00:15:32.716
which is like you have to be in

00:15:32.735 --> 00:15:35.937
a studio with eighteen cameras and

00:15:36.616 --> 00:15:36.996
sensors,

00:15:37.057 --> 00:15:39.297
all the visual sensors all over the body.

00:15:39.496 --> 00:15:41.118
This is four sensors you just stick on

00:15:41.677 --> 00:15:42.837
and simple.

00:15:42.857 --> 00:15:44.339
You can even send somebody out for a

00:15:44.479 --> 00:15:46.639
run in the park and use that data

00:15:47.099 --> 00:15:48.679
to show them how they're doing.

00:15:49.320 --> 00:15:50.820
Or do some online coaching.

00:15:51.419 --> 00:15:53.020
That's been a big hit lately and that's

00:15:53.041 --> 00:15:53.801
been interesting.

00:15:54.687 --> 00:15:55.407
So what would you do there?

00:15:55.447 --> 00:15:56.648
You would talk someone through where to

00:15:56.707 --> 00:15:58.769
place things and set that up and then

00:15:58.948 --> 00:16:00.009
tell them what to do remotely?

00:16:00.528 --> 00:16:01.889
You would use your video AI.

00:16:02.009 --> 00:16:04.811
So if you have the video AI application

00:16:04.951 --> 00:16:06.211
and you're on Zoom right now,

00:16:06.351 --> 00:16:08.413
I can just hold open my iPad and

00:16:08.472 --> 00:16:10.673
start filming any movement that I want.

00:16:10.874 --> 00:16:12.634
And then I can scroll through and teach

00:16:12.673 --> 00:16:13.514
them like, hey,

00:16:13.534 --> 00:16:14.514
during your single leg squat,

00:16:14.534 --> 00:16:16.735
you're going into valgus here, you know,

00:16:16.895 --> 00:16:18.576
looking at the shin angle versus the trunk

00:16:18.636 --> 00:16:20.258
angle on your on your squat from the

00:16:20.298 --> 00:16:20.837
lateral view.

00:16:23.392 --> 00:16:26.594
There's no good story without tension,

00:16:26.953 --> 00:16:27.174
right?

00:16:27.195 --> 00:16:28.534
There's got to be pain that you're

00:16:28.615 --> 00:16:29.176
solving.

00:16:29.296 --> 00:16:31.157
So let's ask this.

00:16:31.437 --> 00:16:34.099
If PTs or healthcare professionals don't

00:16:34.198 --> 00:16:35.940
evolve their movement standards,

00:16:36.740 --> 00:16:39.142
what happens to our positions in MSK care?

00:16:39.182 --> 00:16:40.402
I feel like we just did an episode

00:16:40.422 --> 00:16:41.363
on this a couple days ago,

00:16:41.383 --> 00:16:43.904
which is everywhere else in medicine,

00:16:44.044 --> 00:16:45.424
which we like to say movement is medicine,

00:16:45.625 --> 00:16:47.726
everywhere else in medicine is highly

00:16:47.746 --> 00:16:48.527
measured, right?

00:16:48.626 --> 00:16:50.509
Blood tests and blood pressure,

00:16:50.548 --> 00:16:52.230
things are measured very, very precisely.

00:16:53.029 --> 00:16:54.792
And maybe in our professions for a while

00:16:54.831 --> 00:16:55.952
now, we've just said, you know,

00:16:56.013 --> 00:16:58.815
good enough or things like about or we

00:16:58.855 --> 00:17:01.738
all know how accurate a goniometer is or

00:17:01.798 --> 00:17:03.298
is not, right?

00:17:03.359 --> 00:17:04.519
Where's the tension in the story?

00:17:04.559 --> 00:17:06.281
What happens if we don't evolve towards

00:17:06.321 --> 00:17:07.202
something like this?

00:17:08.702 --> 00:17:11.806
already happening right i i think the

00:17:11.865 --> 00:17:15.489
value of pts are just not valued as

00:17:15.528 --> 00:17:18.631
highly as they should be with the with

00:17:18.651 --> 00:17:19.771
the amount of value that they're actually

00:17:19.832 --> 00:17:23.055
adding to the healthcare system um showing

00:17:23.075 --> 00:17:26.198
the numbers quantifying is one of the

00:17:26.238 --> 00:17:29.000
pieces of the puzzle that can can help

00:17:29.099 --> 00:17:30.942
add to our story um

00:17:32.843 --> 00:17:33.963
The other part is efficiency.

00:17:34.943 --> 00:17:36.424
That's really where I'm targeting a lot of

00:17:36.464 --> 00:17:37.045
my energy,

00:17:37.965 --> 00:17:42.048
which is if you can observe somebody doing

00:17:42.087 --> 00:17:42.667
certain movements,

00:17:44.469 --> 00:17:47.990
a video AI with the use of AI

00:17:48.090 --> 00:17:50.452
algorithms can help PTs in their

00:17:50.492 --> 00:17:51.653
decision-making process.

00:17:52.233 --> 00:17:54.174
Now, that might be scary for some PTs,

00:17:54.194 --> 00:17:56.175
like now I'm being replaced by AI.

00:17:56.675 --> 00:17:57.957
No, you're being enhanced by AI.

00:17:57.977 --> 00:17:59.798
You're being optimized, and you're

00:18:00.557 --> 00:18:02.199
you know you're still the decision maker

00:18:02.499 --> 00:18:04.701
as the pt but now you have a

00:18:04.961 --> 00:18:06.821
now you have a partner an agent who's

00:18:07.041 --> 00:18:09.123
helping you in that decision making and

00:18:09.463 --> 00:18:11.924
we're really honing in on that now well

00:18:11.984 --> 00:18:14.527
i think like i mean everyone's tracking

00:18:14.586 --> 00:18:18.009
everything or rings apple watches so if

00:18:18.028 --> 00:18:19.829
you're not jumping on board they're going

00:18:19.849 --> 00:18:23.672
to find another clinic that will i was

00:18:23.711 --> 00:18:25.292
just having a conversation about this

00:18:25.333 --> 00:18:25.634
which is

00:18:28.211 --> 00:18:30.375
The answer is usually fear or ego or

00:18:30.435 --> 00:18:32.400
uncomfortableness or imposter syndrome,

00:18:32.621 --> 00:18:32.881
right?

00:18:32.941 --> 00:18:33.122
Like...

00:18:34.215 --> 00:18:36.518
I would never put together an affiliate

00:18:36.557 --> 00:18:39.299
list to suggest products to my patients.

00:18:39.319 --> 00:18:40.381
That would be ridiculous.

00:18:41.000 --> 00:18:42.281
But half of your staff on the way

00:18:42.321 --> 00:18:43.163
out the door saying, well,

00:18:43.182 --> 00:18:44.103
what would you get for this?

00:18:44.143 --> 00:18:45.124
And you'd say, oh, I do that.

00:18:45.163 --> 00:18:46.724
Just go on Amazon and search this.

00:18:47.425 --> 00:18:49.086
But the fact that you'd curate a list

00:18:49.186 --> 00:18:51.328
to do that is blasphemy.

00:18:51.749 --> 00:18:53.730
The thing is what we've known or I've

00:18:53.770 --> 00:18:54.391
seen in history,

00:18:54.770 --> 00:18:56.432
the things that are blasphemy now,

00:18:57.509 --> 00:19:00.691
are commonplace several years later like

00:19:00.770 --> 00:19:02.311
and it's usually the people who embrace

00:19:02.352 --> 00:19:05.153
the thing that's scary or uncomfortable or

00:19:05.213 --> 00:19:08.595
blasphemous are the ones that usually i

00:19:08.615 --> 00:19:10.195
don't know i would say get ahead but

00:19:10.215 --> 00:19:12.017
like usually get ahead or stay that's the

00:19:12.057 --> 00:19:12.817
reason they are ahead

00:19:14.647 --> 00:19:15.248
Yeah.

00:19:15.508 --> 00:19:17.229
Why don't you say that I'm actually

00:19:17.489 --> 00:19:20.068
working on a partnership with a product

00:19:20.088 --> 00:19:22.049
company that that can be something that we

00:19:22.089 --> 00:19:24.029
might integrate to into our products.

00:19:24.390 --> 00:19:26.810
Like as, as an assessment is done,

00:19:26.851 --> 00:19:27.770
as analysis is done,

00:19:28.451 --> 00:19:31.030
a product could be recommended to patients

00:19:31.131 --> 00:19:31.550
right there.

00:19:32.451 --> 00:19:33.291
Ultimately, there,

00:19:33.551 --> 00:19:35.751
we could even include links and make it

00:19:36.112 --> 00:19:38.653
really automate exactly that I'm a big fan

00:19:38.732 --> 00:19:41.012
of not necessarily endorsing products,

00:19:41.032 --> 00:19:43.614
but suggesting products to patients.

00:19:44.635 --> 00:19:46.557
I think it's knowing who your patient is

00:19:46.616 --> 00:19:47.498
too, right?

00:19:47.617 --> 00:19:50.159
Like if there's someone who like runners,

00:19:50.298 --> 00:19:52.401
they're typically going to want to know

00:19:52.601 --> 00:19:54.561
all of the data right here, right now,

00:19:54.602 --> 00:19:56.063
they'll tell other friends about it.

00:19:57.022 --> 00:19:57.103
Um,

00:19:57.202 --> 00:19:58.983
if it's someone who's not as tech savvy,

00:19:59.003 --> 00:20:00.565
maybe I wouldn't recommend it.

00:20:00.625 --> 00:20:02.486
I'd still do it in the clinic, but,

00:20:03.787 --> 00:20:05.928
um, maybe not at home,

00:20:06.108 --> 00:20:07.890
but you just have to know your patient

00:20:07.910 --> 00:20:08.349
for sure.

00:20:10.022 --> 00:20:10.442
Understood.

00:20:11.483 --> 00:20:13.483
What didn't I ask or what are some

00:20:13.544 --> 00:20:15.065
frequently asked questions that you get

00:20:15.105 --> 00:20:17.444
that we didn't cover from people that are

00:20:17.505 --> 00:20:19.385
leaning into adopt something like this

00:20:19.625 --> 00:20:20.946
that maybe we didn't talk about yet?

00:20:22.386 --> 00:20:22.646
Mako,

00:20:22.707 --> 00:20:23.887
maybe you want to talk about some of

00:20:23.968 --> 00:20:27.509
the use cases that we've already deployed

00:20:27.548 --> 00:20:30.710
or that are in clinics and with sports

00:20:30.730 --> 00:20:32.029
teams and other groups now?

00:20:32.529 --> 00:20:33.711
Yeah, so the system...

00:20:34.881 --> 00:20:37.402
typically we will sell the system to

00:20:37.442 --> 00:20:40.962
clinicians um a lot of the time so

00:20:41.042 --> 00:20:43.123
when i worked for a large outpatient

00:20:43.163 --> 00:20:45.544
division i'm not a pt i was trying

00:20:45.584 --> 00:20:48.825
to build a cash pay program i didn't

00:20:48.845 --> 00:20:50.204
want so i'm an athletic trainer i didn't

00:20:50.224 --> 00:20:51.905
want to be on the sidelines so what

00:20:51.986 --> 00:20:53.865
i did is i did mass testings out

00:20:53.885 --> 00:20:55.767
at the schools so i was capturing

00:20:56.106 --> 00:20:57.729
healthy individuals so i was bringing the

00:20:57.769 --> 00:20:59.911
system out capturing healthy individuals

00:20:59.931 --> 00:21:02.353
that's getting my company's name out there

00:21:02.532 --> 00:21:04.034
my name out there so if and when

00:21:04.075 --> 00:21:05.935
they do get injured they can come see

00:21:06.056 --> 00:21:07.297
us because we have that baseline

00:21:07.317 --> 00:21:07.798
assessment

00:21:08.798 --> 00:21:10.440
We typically charge cash for that.

00:21:10.480 --> 00:21:12.401
And then we get gained referrals off of

00:21:12.441 --> 00:21:12.780
it too.

00:21:12.800 --> 00:21:15.321
So it's a tool in your toolkit to

00:21:15.442 --> 00:21:16.481
gain referrals.

00:21:17.021 --> 00:21:18.823
I also brought it into surgeons.

00:21:18.863 --> 00:21:21.403
So we have a number of surgeons referring

00:21:21.463 --> 00:21:24.325
directly in for our AMI assessment at six

00:21:24.365 --> 00:21:25.105
months post-op,

00:21:25.266 --> 00:21:26.905
whether they were our patient or not.

00:21:26.986 --> 00:21:28.686
So that was a great opportunity for us

00:21:28.727 --> 00:21:30.186
to say to the patient, hey,

00:21:30.207 --> 00:21:31.387
do you want to continue to work with

00:21:31.528 --> 00:21:33.328
us or while we have this test and

00:21:33.348 --> 00:21:34.249
we keep you on track?

00:21:34.789 --> 00:21:36.030
or we can send these results over to

00:21:36.070 --> 00:21:36.590
the PT.

00:21:37.231 --> 00:21:40.174
So it's not only are you capturing data,

00:21:40.214 --> 00:21:43.058
it's a great referrals like tool.

00:21:44.339 --> 00:21:47.182
So outpatient referrals into with the

00:21:47.202 --> 00:21:47.644
docs,

00:21:48.104 --> 00:21:49.605
current patients that we're using the

00:21:49.645 --> 00:21:50.346
system on.

00:21:50.567 --> 00:21:54.371
Yeah.

00:21:54.471 --> 00:21:55.172
Anything else, Dan?

00:21:55.192 --> 00:21:55.332
Yeah.

00:21:56.030 --> 00:21:56.431
Yeah, I mean,

00:21:56.932 --> 00:22:00.094
we also have workplace safety modules and

00:22:00.473 --> 00:22:00.993
sensors.

00:22:01.414 --> 00:22:07.419
So a bunch of companies are actually using

00:22:07.638 --> 00:22:11.181
our sensors in the workplace to monitor

00:22:12.442 --> 00:22:15.544
at-risk employees in factories or assembly

00:22:15.564 --> 00:22:16.505
lines, things like that.

00:22:18.165 --> 00:22:19.365
Return to work, of course,

00:22:19.405 --> 00:22:21.768
we're working on workers comp,

00:22:21.827 --> 00:22:24.789
building a partnership with workers comp

00:22:24.829 --> 00:22:28.432
software company to facilitate FCEs.

00:22:28.451 --> 00:22:31.834
That's something that is a huge headache

00:22:31.854 --> 00:22:32.814
for a lot of PTs.

00:22:33.214 --> 00:22:36.155
Could be a six hour test where we

00:22:36.195 --> 00:22:37.757
have this idea that we could narrow it

00:22:37.777 --> 00:22:39.157
down to four hours easily,

00:22:39.218 --> 00:22:40.578
maybe somewhere between two and four

00:22:40.638 --> 00:22:40.979
hours.

00:22:41.839 --> 00:22:42.940
And Mac,

00:22:43.000 --> 00:22:44.340
I'm not sure if you could talk about

00:22:44.381 --> 00:22:45.501
it, but women's health.

00:22:46.771 --> 00:22:50.153
So we're just in the very early stages

00:22:50.192 --> 00:22:51.752
of working through pelvic health.

00:22:51.992 --> 00:22:53.753
So we have a spine module.

00:22:54.054 --> 00:22:56.233
Our spine module assesses active range of

00:22:56.253 --> 00:22:57.213
movement of the spine.

00:22:57.253 --> 00:22:59.515
So flexion, extension, lateral flexion,

00:22:59.555 --> 00:23:00.154
rotation.

00:23:00.734 --> 00:23:02.796
And now we're adding in an EMG sensor.

00:23:02.976 --> 00:23:03.796
So for instance,

00:23:03.955 --> 00:23:06.236
I had an IMU sensor on my spine

00:23:07.057 --> 00:23:08.096
capturing the movement.

00:23:08.356 --> 00:23:09.957
And then I had an EMG on my

00:23:09.997 --> 00:23:12.438
transverse ab and then one on my QL.

00:23:13.178 --> 00:23:15.859
And so what it's showing is biofeedback.

00:23:15.880 --> 00:23:16.820
So it's showing me, oh,

00:23:16.881 --> 00:23:18.561
I'm lighting up through my back a little

00:23:18.602 --> 00:23:20.003
bit too much when I should be using

00:23:20.044 --> 00:23:20.564
my core.

00:23:20.624 --> 00:23:23.086
So being able to see that data on

00:23:23.125 --> 00:23:25.167
the screen has been really helpful.

00:23:25.428 --> 00:23:26.689
Those are early stages.

00:23:26.769 --> 00:23:29.211
It's something that we'll release with our

00:23:29.250 --> 00:23:30.971
spine module here in a little bit.

00:23:32.153 --> 00:23:33.074
But the thing I think

00:23:33.959 --> 00:23:35.878
What we do really well at Dorsivee is

00:23:35.939 --> 00:23:37.559
we listen to our customers.

00:23:37.720 --> 00:23:40.220
So we have been in pilots with our

00:23:40.480 --> 00:23:42.661
large outpatient divisions to understand

00:23:42.800 --> 00:23:44.000
what do you want to use?

00:23:44.320 --> 00:23:45.922
What assessments are we lacking?

00:23:46.001 --> 00:23:47.461
How would you like to assess these

00:23:47.501 --> 00:23:48.021
patients?

00:23:48.602 --> 00:23:50.522
And then we'll capture that information

00:23:50.563 --> 00:23:52.202
and actually add it to our product.

00:23:53.104 --> 00:23:54.903
So the EMG sensors are coming soon.

00:23:54.923 --> 00:23:55.663
It's really exciting.

00:23:55.683 --> 00:23:56.423
Yeah.

00:23:56.443 --> 00:23:57.984
This is the direction things are going,

00:23:58.224 --> 00:23:58.464
right?

00:23:58.565 --> 00:23:58.845
I mean,

00:23:58.904 --> 00:24:00.704
what used to cost a hundred thousand

00:24:00.724 --> 00:24:02.365
dollars in a lab with force plates and

00:24:02.405 --> 00:24:03.586
things you had to place on people.

00:24:05.333 --> 00:24:07.354
are now going to be measurable by my

00:24:07.394 --> 00:24:08.614
doorbell camera, right?

00:24:09.153 --> 00:24:09.374
Yep.

00:24:09.673 --> 00:24:10.555
Yep.

00:24:10.595 --> 00:24:10.994
Exactly.

00:24:11.015 --> 00:24:11.295
Exactly that.

00:24:11.434 --> 00:24:16.176
And we look at it as the –

00:24:14.496 --> 00:24:15.836
I've been with this company for a few

00:24:15.875 --> 00:24:16.257
months now,

00:24:16.457 --> 00:24:18.916
and I really thought the whole thing was

00:24:18.977 --> 00:24:22.398
about the sensors and the hardware.

00:24:23.038 --> 00:24:24.519
This is a company that developed the

00:24:24.558 --> 00:24:29.000
hardware to really high standards,

00:24:29.921 --> 00:24:31.201
but it's really a software company.

00:24:31.622 --> 00:24:34.404
So what we can do, like Maka said,

00:24:34.464 --> 00:24:36.546
is we can listen to our customers and

00:24:36.625 --> 00:24:38.847
customize just about anything when it

00:24:38.867 --> 00:24:40.449
comes to measuring human movement.

00:24:40.469 --> 00:24:42.790
And that's super fascinating.

00:24:42.871 --> 00:24:43.672
You know, I've always been,

00:24:44.571 --> 00:24:45.633
I've been fascinated by that.

00:24:45.692 --> 00:24:47.094
Like when I was a kid, you know,

00:24:47.134 --> 00:24:48.556
you'd see like robotics and things like

00:24:48.576 --> 00:24:48.875
that.

00:24:49.736 --> 00:24:50.797
As I got into PT, I was like,

00:24:50.817 --> 00:24:52.198
this is the coolest part of PT,

00:24:52.699 --> 00:24:53.638
looking how people move.

00:24:54.680 --> 00:24:57.542
And then like being able to like really

00:24:57.563 --> 00:24:58.163
understand

00:24:58.282 --> 00:25:00.403
tech it out and measure it and then

00:25:00.443 --> 00:25:00.983
apply it.

00:25:01.523 --> 00:25:04.125
That's, that's awesome to me.

00:25:04.184 --> 00:25:04.484
Perfect.

00:25:04.505 --> 00:25:04.684
All right.

00:25:04.704 --> 00:25:05.705
We have a tradition on the show.

00:25:05.746 --> 00:25:09.707
It is called the parting shot.

00:25:09.767 --> 00:25:11.788
This is the parting shot.

00:25:12.347 --> 00:25:13.729
One last mic drop moment.

00:25:14.409 --> 00:25:15.209
No pressure.

00:25:15.669 --> 00:25:17.789
Just your legacy on the line.

00:25:19.384 --> 00:25:21.105
I do want to say thanks to U.S.

00:25:21.144 --> 00:25:21.904
Physical Therapy.

00:25:21.944 --> 00:25:23.306
If you're tired of working for companies

00:25:23.346 --> 00:25:24.727
run by people who just don't understand

00:25:24.767 --> 00:25:26.208
PT, at U.S.

00:25:26.248 --> 00:25:26.968
Physical Therapy,

00:25:27.008 --> 00:25:28.848
they're clinician-led from top to bottom.

00:25:29.048 --> 00:25:30.130
It means your voice matters,

00:25:30.509 --> 00:25:31.410
your growth matters,

00:25:32.090 --> 00:25:33.612
and your career can actually feel like

00:25:33.632 --> 00:25:34.152
yours again.

00:25:34.192 --> 00:25:35.913
Explore opportunities right now at

00:25:36.073 --> 00:25:37.292
USPH.com.

00:25:37.314 --> 00:25:38.953
That's USPH.com.

00:25:39.295 --> 00:25:41.435
Two guests means two parting shots.

00:25:42.455 --> 00:25:43.877
Who wants to go first?

00:25:44.018 --> 00:25:45.599
I should say, who wants to go second?

00:25:45.881 --> 00:25:48.243
Because usually it's harder to follow up.

00:25:48.284 --> 00:25:49.125
But parting shot,

00:25:49.144 --> 00:25:50.346
what would you leave the audience with?

00:25:50.365 --> 00:25:52.229
What's your mic drop moment?

00:25:52.269 --> 00:25:53.150
Ladies first, Macca.

00:25:54.567 --> 00:25:55.929
Okay, my mic drop.

00:25:56.048 --> 00:25:58.191
So being in sports med,

00:25:58.431 --> 00:26:00.673
I would just say rehab athletes like

00:26:00.732 --> 00:26:01.232
athletes.

00:26:01.432 --> 00:26:02.713
Use the objective data.

00:26:02.814 --> 00:26:04.214
Don't use just your eye.

00:26:04.415 --> 00:26:05.375
Use our sensors.

00:26:05.936 --> 00:26:07.018
Use the video AI.

00:26:07.357 --> 00:26:09.378
Build the relationships with the athletes.

00:26:09.579 --> 00:26:10.660
Build the relationships with your

00:26:10.680 --> 00:26:11.260
patients.

00:26:11.361 --> 00:26:13.102
And it'll be so much easier for you

00:26:13.122 --> 00:26:14.022
for the long haul.

00:26:14.083 --> 00:26:15.364
And they'll come back if they need you

00:26:15.403 --> 00:26:15.743
again.

00:26:15.864 --> 00:26:18.445
But rehab athletes like athletes is my mic

00:26:18.465 --> 00:26:18.866
drop moment.

00:26:18.886 --> 00:26:19.267
All right.

00:26:22.240 --> 00:26:23.961
I am a practicing PT,

00:26:24.000 --> 00:26:27.221
so I feel your pain out there.

00:26:27.761 --> 00:26:30.083
Using this Dorsibee system has made my

00:26:30.123 --> 00:26:33.804
life easier as a practicing PT for

00:26:34.243 --> 00:26:36.444
education patients, documentation,

00:26:36.984 --> 00:26:41.625
and facilitating decision-making.

00:26:43.027 --> 00:26:44.767
We have to think about so many things

00:26:44.846 --> 00:26:46.248
as a PT all at one time.

00:26:46.647 --> 00:26:48.409
Having a partner in the clinic with me

00:26:48.669 --> 00:26:49.628
has been super helpful.

00:26:50.393 --> 00:26:50.653
Awesome.

00:26:50.732 --> 00:26:51.713
And if people want more information,

00:26:51.734 --> 00:26:52.474
we'll put it in the show notes,

00:26:52.494 --> 00:26:53.395
but where would you send someone?

00:26:54.857 --> 00:26:57.621
They can go to our website, dorsivee.com,

00:26:57.881 --> 00:26:59.863
or they can connect with me directly,

00:27:00.044 --> 00:27:01.825
mstewart at dorsivee.com.

00:27:02.326 --> 00:27:02.786
Perfect.

00:27:04.709 --> 00:27:05.388
All right.

00:27:05.449 --> 00:27:06.390
Dan, appreciate the time.

00:27:07.832 --> 00:27:08.413
Thank you, Jimmy.

00:27:08.512 --> 00:27:09.093
This was awesome.

00:27:09.594 --> 00:27:10.474
Keep up the great work, man.

00:27:10.954 --> 00:27:11.395
Appreciate it.

00:27:12.849 --> 00:27:13.911
That's it for this one,

00:27:14.191 --> 00:27:15.852
but we're just getting warmed up.

00:27:16.333 --> 00:27:18.233
Smash follow, send it to a friend,

00:27:18.453 --> 00:27:20.115
or crank up the next episode.

00:27:20.635 --> 00:27:21.636
Want to go deeper?

00:27:21.997 --> 00:27:26.059
Hit us at pgpinecast.com or find us on

00:27:26.099 --> 00:27:28.642
YouTube and socials at pgpinecast.

00:27:29.061 --> 00:27:31.344
And legally, none of this was advice.

00:27:31.403 --> 00:27:33.184
It's for entertainment purposes only.

00:27:33.224 --> 00:27:33.766
Bullshit!

00:27:34.826 --> 00:27:35.406
See, Keith?

00:27:35.606 --> 00:27:36.688
We read the script.

00:27:36.968 --> 00:27:37.628
Happy now?