New Technology in PT (Full Version)

All Forums >> [RehabEdge Forum] >> The Future of PT



Message

Inventor2 -> New Technology in PT (April 21, 2008 10:13:58 PM)

Hello to all,
  Thank you for allowing me to be a part of your forum, I have read some very informative discussions in a variety of posts. I have a substantial amount of respect for the services that each and every one of you provide to patients that are lucky enough to have exposure to your treatment.
   I would like start off by describing who I am and what I do...

   I am an engineer and half of an emerging market, technology development team. We have discovered a new technology/method in continual strength monitoring, improvement, and reporting and are in the process of developing this technology into a marketable product. All that aside, I'd like to solicit some input from professionals, namely, you.

1. What are the limitations of resistance bands in patient strength gains or PT monitoring of patient progress over various time periods?
2. What are the limitations in standard weighted systems for patient progress and PT monitoring?
3. What are the maximum and minimum resistance weight or "pounds of pull" that you would use to treat a patient.
4. Overall, what would you like to see available from a technology standpoint that would assist you in more effectively treating a patient, reporting, etc...

Again, I appreciate your time and I thank you for allowing me to be a part of your forum.

I look forward to your responses and wish you all the best in your practice.
Thanks again. 



Sebastian Asselbergs -> RE: New Technology in PT (April 21, 2008 10:34:32 PM)

Don't have to be quite that heavy on the butter, but....Thanks anyway.

I am not so sure that I see any significant rehab value in any (of MY) answers to the questions you pose here.
#1 answer: no limitations
#2 do not use standard weighted systems for patient progress
#3 depends on the patient and the condition treated
#4 actually, I would like to see LESS technology in the direct treatment of a patient.



SJBird55 -> RE: New Technology in PT (April 22, 2008 6:35:52 AM)

4.  I, personally, can't count.  As I'm watching performance, commenting on performance and giving feedback on performance, I forget which finger I'm on in keeping track of the repetitions.  (As a side, I had an older lady complain that I couldn't count.  As luck would have it I told her it was her daughter's fault because her daughter was my first grade teacher.  LOL)

In an outpatient orthopaedic setting:  Considering that an episode of care might be 4-8 weeks or less, do you really think that "strengthening" occurs or our "reporting" focuses on "strength" gains?

Inventor2, let me give you a glimpse of my day.  I spend a ton of time talking.  Lots of motivating and positive affirmation for little bits of progress.  I use my hands on tissues and joints.  There are always functional activities patients want to do by the time they are discharged - I mentally break whatever activity up into components and attempt to determine where the patient is going to have difficulty or pain and I then try to implement pieces of that activity into their therapy program and as the pieces are performed adequately, then begin putting them together as the functional activity itself.  And, yes, patients do resistive activities.  Do I report in my documentation strength gains?  Sometimes, but more often than not, I'm not reporting any strength gains because specific strength gains are not generally any of my goals.  My goals and my reporting information are more functional.

And, in case you were wondering, no, I don't use a Wii for strengthening.  ;)  (Private PT joke for some of us.)



Shill -> RE: New Technology in PT (April 22, 2008 8:20:24 AM)

Inventor,
With the questions you have posed, you likely already have a product in mind, and know the answers to your own questions.  What is it?  C'mon man, rock our world.



TexasOrtho -> RE: New Technology in PT (April 22, 2008 8:48:46 AM)

Pass...



Inventor2 -> RE: New Technology in PT (April 22, 2008 10:28:26 AM)

SJBird55,
  How is patient functionality measured? Is it more qualitative v. quantitative?
  Is the basis of measurement patient subjectivity? As an example, a patient comes to you with shoulder pain, their goal is to play golf without pain, treatment is determined and given for the specified time period (4-8 weeks or less), the patient plays golf with no pain. Is it then determined that treatment was successful?
  Could you explain how strength and patient functionality are unrelated? Do you have any examples where strength plays a large part in patient functionality?

Perhaps you could recommend some quick reads, internet reference material, etc...I understand that this subject gets deep and I don't want to take much of your time.
Thanks in advance,



Inventor2 -> RE: New Technology in PT (April 22, 2008 10:34:56 AM)

Shill,
  We're in the process of developing this product. I have what I think are answers, but I'm certainly not a therapy professional. I would like to gain a more robust understanding from professionals that deal with these issues on a day to day basis.



Sebastian Asselbergs -> RE: New Technology in PT (April 22, 2008 11:11:20 AM)

I can't help it. I must ask:
Since you are not a rehab professional, why are you here asking these questions? We can't do your work for you - you think you have an invention, then go get educated.
You need to take a ton of courses (bio, neuro, anat, physiol etc etc) as well as understand outcome measurements. Even MDs with all their education, have very little "robust" understanding of what rehab pros do.
This stuff is more complex than just asking here. Besides, internet answers are not the equivalent of an education, and none of us are getting paid for educating the un-educated.



Tom Reeves DPT ATC -> RE: New Technology in PT (April 22, 2008 3:16:13 PM)

I think he is trying to become educated.  He can simply talk to more people online than he can in person.  relax man.



Sebastian Asselbergs -> RE: New Technology in PT (April 22, 2008 6:18:20 PM)

Any more relaxed and I would be asleep......



BTW, your post was much more helpful to him....[;)][:D]



Inventor2 -> RE: New Technology in PT (April 22, 2008 6:45:17 PM)

Sebastian,
   You responded, and I will respond in RED.
 
I can't help it. I must ask: 
Since you are not a rehab professional, why are you here asking these questions?
Who better to ask? This is a professional forum; I'm looking for professional opinions.
 
We can't do your work for you (Please don't)- you think you have an invention, then go get educated. I'm very well educated sir. I'm not attempting to practice therapy or rehab, only focus on my core competency, which is technological development in an effort to make lives better and tasks easier.
You need to take a ton of courses (bio, neuro, anat, physiol etc etc) as well as understand outcome measurements. A bit overkill for what I'm doing.
Even MDs with all their education, have very little "robust" understanding of what rehab pros do. This may be the root of your hostility.
This stuff is more complex than just asking here. I think my questions were a bit straight forward, please don't complicate them.
Besides, internet answers are not the equivalent of an education, and none of us are getting paid for educating the un-educated.
The internet is actually a significant advancement in education (Harvard, Yale, MIT, and Notre Dame would agree), I only posted this message at 10pm yesterday and already I've had 94 professional views and several replies...pretty good turnout for an uneducated bloke, huh. [sm=s201.gif]
 
Sir, I am not interested in conflict, only resolution. If I have offended you or anyone else in this forum, I apologize as it was not my intention. I'm just attempting to see things from your point of view. If you simply don't know the answers to the questions I'm posing, then please allow someone else the opportunity for input without turning my post into something it was not intended to be.
Thank you in advance,

Inventor2



SJBird55 -> RE: New Technology in PT (April 22, 2008 7:42:59 PM)

Inventor,

I use standardized outcome measures that are valid and reliable to determine the change in function of the patient.  Since the patient completes the tool, you could say the information is "subjective" but the scores could be interpreted as being "objective."  The tools that I use do have a known minimal clinically important difference (which means a clinically relevant amount of change did occur).  The tools are currently accepted by most payers.

If playing golf was the only goal, then yes, treatment was successful.  But, sport activities are  generally not payable goals and most of my documentation lists 4-5 goals. 

Strength definitely plays a role in function.  For the older population, as muscular changes occur in the lower extremities, the ability to ascend and descend stairs declines.  The ability to move from sit to stand declines.  There are actually performance measures that we can use to objectively track performance changes that will at times indirectly measure functional strength improvement.

I have no idea where to point you for references.  References that have what content specifically?



Inventor2 -> RE: New Technology in PT (April 22, 2008 7:58:25 PM)

SJBird55,
   Thank you for the detail. I think I have a better birds eye view of the approach. The references that I was asking about are related to the tools and performance measures that you use to objectively or indirectly measure functional strength or overall improvement.

Also, you mentioned the older population. Is the primary age group you treat in this category?

Thanks again.



SJBird55 -> RE: New Technology in PT (April 22, 2008 9:32:11 PM)

Inventor, if you are in the States, the first thing I'd advise would be to look at the reimbursement levels physical therapists receive.  No matter how cool your invention, it might not be a good business decision for a physical therapist to purchase because of the dwindling reimbursement.  I don't even have a clue what you have invented.  Technology costs money... with some payers not reimbursing for 97002 and with some fee schedules around $20-28 for a unit of 97110, I'm sure it would take quite a few patients coming through the doors to pay off the invention.

The older population is not the age group that I predominantly treat.  I am board certified in geriatrics though.  I just gave one quick example of where strength deficits (true strength deficits) lead to decreased function.



Sebastian Asselbergs -> RE: New Technology in PT (April 23, 2008 7:53:16 AM)

Inventor, if you are asking for "opinions" and not prepared to get something you don't like, you are in trouble.
I will answer in BLACK.

I am not hostile at all. Just stated a fact about MDs.

Please read a bit more carefully: I said "internet answers are not the equivalent of an education" ....and you respond with an answer about online university education?!? Thanks for equating us with those lofty institutions!

And if you think that introducing new rehab equipment into the world of therapy does not require a ton  of education  as I indicated, then you have given us a very good example of what is wrong in rehab at this time.

You have not offended at all. I just exercise my right to respond to a series of questions that I found of a specific interest. I thought you might want to know an opinion that shows that there are professionals NOT interested in MORE gadgets, technology, equipment. Believe, I am not the only one. That is rather important when you think of what your product requires: a market.....

The cost of developing a marketable piece of rehab equipment is enormous - so, you can take my post and delete it, or you can use it to consider your options as to your target audience. Whatever you do, all the best.




ianwvu -> RE: New Technology in PT (May 10, 2008 9:58:30 PM)

quote:

ORIGINAL: SJBird55

Inventor, if you are in the States, the first thing I'd advise would be to look at the reimbursement levels physical therapists receive.  No matter how cool your invention, it might not be a good business decision for a physical therapist to purchase because of the dwindling reimbursement.  I don't even have a clue what you have invented.  Technology costs money... with some payers not reimbursing for 97002 and with some fee schedules around $20-28 for a unit of 97110, I'm sure it would take quite a few patients coming through the doors to pay off the invention.

The older population is not the age group that I predominantly treat.  I am board certified in geriatrics though.  I just gave one quick example of where strength deficits (true strength deficits) lead to decreased function.



Inventor, I would say the above quote is going to do worlds for your research guidance.  I could outfit my clinic with the most beneficial , fancy, hi-tech gizmos that get optimal results for my patients, but If I cant equate it to reimbursable codes, the only thing I would accomplish is fixing a few patients before I go bankrupt.

SJ- $20-28?  Is  BCBS one of those fee schedules you are referring to?  If so, I envy you!

Seb,
What do you expect this guy to do? Go to PT school or something for his "education"?  I would assume this forum isn't 100% of his research. 



Sebastian Asselbergs -> RE: New Technology in PT (May 11, 2008 12:16:01 PM)

ianwvu, that would be a good start. We would not have all kinds of "improved", "new", and "wonderful" gizmos being presented without any solid research.
Personally, I do not give a flying hoot whether he studies more or not; like I said, when the group here (of which I am one) gets asked, I will give MY opinion. And he can take or leave it. It is just that there are others like me who are NOT looking for gadgetry to improve our practice, and he needs to know that.



tucker -> RE: New Technology in PT (June 7, 2008 12:44:06 PM)

Inventor2 and others who have an idea for a product,

Stumbled on this thread and thought I'd share my story in product development as it may assist others.  I am a PT specializing in ICU and burn rehab.  My problem was mobilizing patients who were severely deconditioned and I felt standing patients with manpower or a tilt table were inappropriate (must have a clear problem)...decided to modify the tilt table to make it a leg press device using a patient's body weight that could be transported to a patient's room.  Made a prototype and tested (possible solution).  Asked other therapists if this was a problem at other facilities (always get a non-disclosure form..NDF..signed with each person you talk to about new technology...without a NDF, they can steal the idea and you lose the ability to patent the device).  You must test the market if the device would be sold to make a profit. 

After assessing the market for similar devices and having a patent attorney do a patent search, we filed a provisional patent.  This type of application is cheaper than a non-provisional and secures the filing date which gives you the 'patent pending' status.  You will have one year to test the market and if desired, file a non-provisional patent which is $5-8K for a utility patent (protects the function of the device) and gives around 18 years to solely sell it. 

After filing, we aquired IRB approval to begin testing the device with patients and published a case series on it's use in a peer-reviewed journal.  This step is crucial I feel to begin showing evidence.  It also gives the inventor some leverage when seeking a manufacturer to license or assign your patent...which you collect royalties.  The other option is to develop a small business and manufacture/market/and sell the device with takes $$$ but has potential to make more profit.  NIH has grants that can assist with this step...look into the SBIR and STTR programs.

After filing the provisional and having publication, I sought a manufacturer to develop it...which was turned down by at least 14.  Finally I found the right manufacturer and we drafted an agreement with the assistance of a patent attorney...a must to understand the legal terms.

After we signed an Agreement, I worked with a few engineers to test several prototypes and agreed on a final design.  The device (The Moveo XP by Chattanoga Group) is now on the market and being used at several ICUs...which is by far the most rewarding part.

It was a challenging, 8-year, nerve racking process, but in the end, I am so glad that I persisted.  If you believe that your idea can help others, do not give up on it.

Video: http://youtube.com/watch?v=GrxooU9WI9k

Darin



SJBird55 -> RE: New Technology in PT (June 11, 2008 12:47:42 AM)

We've been without power for quite a few days and I happened to actually read the Advance (not my favorite reading material, but when no power, better than nothing).  I saw you had an article in the issue, Darin.



tucker -> RE: New Technology in PT (August 9, 2008 12:39:01 PM)

By the way...Here is the story behind the Moveo XP:

http://www.caller.com/news/2008/aug/09/father-helps-son-realize-rehab-idea/



Page: [1]



Forum Software © ASPPlayground.NET Advanced Edition 2.5.5 Unicode

0.094