<p>More than 80% of people experience back pain at some point in their lives, <a href="http://www.oregonlive.com/health/index.ssf/2016/02/healthy_over_60_back_pain_gets.html" target="_blank" rel="noopener">reports The Oregonian/OregonLive.</a></p><p></p><p>Dr. Khoi Than, a spine surgeon with Oregon Health &amp; Science University, says he operates on only a minority of cases of back pain because "issues that can be improved or stabilized with surgery are limited."</p><p></p><p>"If people have pain that seems to be coming from their joints or their muscles, that really can't be fixed with surgery," says Than. The treatment he prescribes typically involves physical therapy.</p><p></p><p>"We try to reassure people that a return to activity will help them get better faster," says physical therapist Tasha Macilveen. "In almost all people with back pain, core, hip, and leg muscle weakness are common."</p><p></p><p>"I really encourage people to think of (exercise) as brushing and flossing of their teeth," says Macilveen. "Long-term maintenance of their home program is really important."</p><p></p><p>If you're interested in a 100% home program, one that may improve your back pain without having to travel to and from doctors or clinics, you can try a <a href="https://www.simpletherapy.com/programs/lower-back-pain/">free session of SimpleTherapy's lower back program</a>.</p>

Surgery is  Not Always the Best Option

<p>As self-insured employers and health plans consider implementing musculoskeletal (MSK) solutions to benefit their employees and members, it's crucial to understand the effectiveness of these programs. Many competing MSK solutions in the market claim to reduce surgeries and opioid use, basing their impact on patient-reported surgical intent, also sometimes crafted as “Avoided Surgeries.“ There is insufficient evidence from peer-reviewed studies to support the use of this metric in measuring surgery reduction. Additionally, it may not provide an accurate reflection of the actual cost savings from a program. In this blog post, we'll explore why SimpleTherapy chooses not to rely on surgical intent to measure the impact of our virtual physical therapy program and what alternative evidence-based measures should be considered.</p><p>With the rise of virtual physical therapy programs, employers and health plans are often faced with the challenge of choosing the right solution for their members. Amidst the noise and competing claims in the market, one metric that has garnered attention is the reduction of surgical intent as a measure of program success. In this blog post, we discuss the reliability of this metric and provide insights from orthopedic surgeons on the importance of objective data in measuring the impact of virtual physical therapy programs.</p><h3 class="wp-block-heading" id="h-the-flaws-of-surgical-intent-metric">The Flaws of Surgical Intent Metric</h3><p>Using surgical intent as a measure of program impact involves asking members about their likelihood of having surgery in the next 12 months. Although some MSK solutions guarantee returns by calculating savings using surgical intent reduction, there is no proof that reducing surgical intent actually leads to reduced costs in claims. Furthermore, there are no peer-reviewed studies supporting the reliability of this metric for measuring surgery reduction.</p><p>Surgical intent is a subjective measure that can be influenced by various factors, such as the patient's perception of their condition, personal beliefs about surgery, and their understanding of alternative treatments. While it has been used as one of the outcome measures in some clinical studies, often in conjunction with other clinical, functional, and quality-of-life measures, these studies typically assess the effectiveness of interventions in reducing the patient's intention to undergo surgery. They do not provide direct evidence to support surgical intent as a reliable, independent metric for evaluating the true impact on surgical claims and further overestimate the impact of virtual physical therapy or MSK programs in terms of cost.</p><p>Moreover, relying on surgical intent to calculate cost savings assumes a direct correlation between reduced surgical intent and actual cost savings in medical claims. However, there is no proof that reducing surgical intent leads to reduced healthcare costs.</p><h3 class="wp-block-heading" id="h-the-orthopedic-surgeon-s-perspective">The Orthopedic Surgeon's Perspective</h3><figure class="wp-block-image aligncenter size-full is-resized is-style-rounded"><img src="/uploads/2018/09/tae-512.png" alt="Dr. Tae Won Kim" class="wp-image-2415" width="128" height="128"/></figure><blockquote class="wp-block-quote has-text-align-right is-style-large has-text-color has-small-font-size" style="color:#044f6b;font-style:normal;font-weight:300"><p class="has-text-align-center has-text-color" style="color:#1ea5de;font-size:18px">"As a surgeon, my primary focus is on the best course of treatment for my patients, taking into account their unique circumstances and medical history. Relying on a patient-reported measure of surgical intent, a patient's subjective opinion, especially within a short time frame of 6-8 weeks, may not accurately capture the true impact of a physical therapy program. Objective data, such as claims-based cost savings and measurable clinical improvements, are far more reliable indicators of a program's effectiveness"</p><cite><strong>— Tae Won Kim, M.D</strong> <br>Program Director, Orthopaedic Surgery Residency Program<br>Director, Orthopaedic Oncology Center <br>Cooper University  Heath Care</cite></blockquote><p>Orthopedic surgeons also acknowledge the limitations of relying on patient-reported measures like surgical intent. It's difficult to depend on a measure taken just 6-8 weeks after starting a program when the true impact of the program may require a much longer timeframe to become evident. Moreover, it's crucial to consider factors such as the severity of the patient's condition, the patient's overall health, and the potential risks and benefits of surgery, which cannot be captured by simply asking about surgical intent.</p><p>An orthopedic surgeon would likely perceive the patient-reported outcome measure of the likelihood of surgery with skepticism. Surgeons base their decisions on a comprehensive assessment of the patient's condition, medical history, and the severity of their symptoms. They take into account various diagnostic tests, clinical guidelines, and their expertise to determine the most appropriate course of action for the patient.</p><p>A patient-reported measure of the likelihood of surgery, while potentially informative, is subjective and may not accurately reflect the clinical need for surgery. Patients might overestimate or underestimate their need for surgery based on personal beliefs, fear, or lack of understanding of alternative treatment options. As a result, orthopedic surgeons might not rely solely on a patient-reported measure of surgical intent when making a decision about the best course of treatment.</p><p>Orthopedic surgeons may also consider factors such as the patient's functional limitations, pain levels, and response to conservative treatments like physical therapy or medications. They would likely view a combination of these objective measures as a more accurate and reliable way to determine the need for surgery and the potential benefits of non-surgical interventions.</p><h3 class="wp-block-heading" id="h-a-physical-therapists-perspective">A Physical Therapists perspective</h3><p>The time it takes for physical therapy (PT) to reduce the chances of surgery can vary significantly depending on several factors, such as the type and severity of the condition, the patient's overall health, and their adherence to the prescribed PT program.</p><p>In some cases, patients may experience significant improvements in their symptoms within a few weeks or months, while others may require a longer period of consistent physical therapy to achieve noticeable progress. It is essential for patients to follow their PT program diligently and maintain open communication with their healthcare providers to monitor their progress and adjust the treatment plan as needed.</p><figure class="wp-block-image aligncenter size-full is-resized is-style-rounded"><img src="/uploads/2023/06/Kelly_McLaughlin.webp" alt="" class="wp-image-5526" width="138" height="138"/></figure><blockquote class="wp-block-quote has-text-align-right is-style-large has-text-color" style="color:#044f6b"><p class="has-text-align-center has-text-color" style="color:#1ea5de;font-size:18px">"Ultimately, the decision to pursue surgery should be based on a comprehensive evaluation of the patient's condition, response to conservative treatments like PT, and consultation with their healthcare providers. It is important to remember that individual experiences may vary, and there is no one-size-fits-all timeline for the effects of PT in reducing the chances of surgery."</p><cite>— <em>Kelly McLaughlin, DPT, ATC Cert MDT</em></cite></blockquote><h3 class="wp-block-heading" id="h-alternative-measures-for-evaluating-msk-program-impact">Alternative Measures for Evaluating MSK Program Impact</h3><p>It's essential to rely on objective, evidence-based measures when evaluating the effectiveness of a physical therapy or MSK program. This can include functional outcomes, pain reduction, quality of life improvements, and actual healthcare cost savings resulting from reduced surgical procedures, hospitalizations, and medication use.</p><p>SimpleTherapy focuses on such cost savings and is willing to put money at RISK. By using cohort-matched studies and reviewing claims data, we demonstrate the real-world impact of our MSK program on healthcare costs and patient outcomes. This approach demonstrates actual cost savings and reflects the true effectiveness of our virtual physical therapy program. By focusing on real savings, SimpleTherapy is confident in our program's ability to make a difference, and we're willing to put our money at risk to prove it.</p><h3 class="wp-block-heading" id="h-the-simpletherapy-difference-focusing-on-transparency-and-true-cost-savings">The SimpleTherapy Difference: Focusing on Transparency and True Cost Savings</h3><p>At SimpleTherapy, we recognize the need for objective data and transparency in evaluating the impact of our virtual physical therapy program. Our Advanced Claims Analytics Engine (ACE) is designed to help employers gain insights into the true cost savings achieved through our program by analyzing medical claims data and providing accurate, reliable metrics identified in these studies.</p><p>By focusing on cohort-matched studies that review claims data, we can demonstrate the real-world cost savings associated with our program. This approach aligns with the opinions of orthopedic surgeons who emphasize the importance of objective data in measuring program success, as opposed to relying on subjective measures like surgical intent.</p><p>We are confident in our ability to deliver true cost savings and are willing to put our money at RISK. SimpleTherapy is dedicated to providing high-quality, accessible virtual physical therapy services that lead to real, measurable improvements in our users' health and well-being.</p><p>Check-out some of our case studies that showcase the claims-based analysis conducted for our clients.</p><h3 class="wp-block-heading" id="h-conclusion">Conclusion</h3><p>As healthcare decision-makers, it is crucial to be critical of the metrics used to evaluate the effectiveness of MSK solutions. Patient-reported surgical intent is not a reliable, standalone measure for determining the impact of a virtual physical therapy program. Instead, consider evidence-based measures, such as functional outcomes, pain reduction, quality of life improvements, and actual healthcare cost savings. By focusing on these more meaningful metrics, SimpleTherapy aims to provide an effective and accessible solution for musculoskeletal pain management while promoting health equity and diversity.</p>

Debunking the Surgical Intent Metric and Focusing on Real Cost Savings

<p>At SimpleTherapy, we prioritize providing evidence-based, clinically proven methods to help our users manage and reduce pain. While some digital health solutions rely on motion-tracking devices and sensors, SimpleTherapy's approach is grounded in research that supports the efficacy of virtual therapy without the need for additional hardware. In this post, we'll explore the lack of clinical evidence for motion-tracking devices, discuss a recent clinical study conducted with Mount Sinai, and explain how SimpleTherapy effectively delivers appropriate care without these devices.</p><h3 class="wp-block-heading" id="The-Lack-of-Clinical-Evidence-for-Motion-Tracking-Devices:">The Lack of Clinical Evidence for Motion Tracking Devices:</h3><p>Motion tracking devices, such as wearable sensors, are often touted as the future of rehabilitation, but the scientific evidence supporting their use remains limited. According to a systematic review published in the Journal of Medical Internet Research (JMIR), there is a lack of high-quality studies evaluating the effectiveness of sensor-based interventions for musculoskeletal (MSK) disorders<sup>(1)</sup>. The review concludes that more rigorous, controlled trials are needed to establish the validity of these devices in clinical practice.</p><hr class="wp-block-separator has-alpha-channel-opacity"/><figure class="wp-block-image aligncenter size-full"><a href="/uploads/2023/06/Kelly_McLaughlin.webp"><img src="/uploads/2023/06/Kelly_McLaughlin.webp" alt="" class="wp-image-5526"/></a></figure><figure class="wp-block-pullquote has-white-color has-text-color has-background has-small-font-size" style="border-width:40px;border-radius:55px;background:linear-gradient(135deg,rgb(30,165,222) 1%,rgb(46,182,149) 100%);font-style:normal;font-weight:400"><blockquote><p><strong><em>“Clinical decision-making revolves around pain and the mechanical responses to movements. Therefore, it is not necessary to use sensors that only record movement, but rather, it is more clinically relevant to obtain subjective and mechanical response to those particular movements to prescribe the best care for the patient.”</em></strong></p><cite>- Kelly McLaughlin, DPT, ATC Cert MDT <br>Director of MSK Programs | SimpleTherapy Inc.</cite></blockquote></figure><hr class="wp-block-separator has-alpha-channel-opacity"/><h3 class="wp-block-heading" id="SimpleTherapy's-Clinical-Study-with-Mount-Sinai:">SimpleTherapy's Clinical Study with Mount Sinai</h3><p>SimpleTherapy recently conducted a clinical study with The&nbsp;Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai in NYC to further investigate the effectiveness of our virtual physical therapy platform without the use of motion-tracking devices. The study conducted by SimpleTherapy and Mt. Sinai involved a retrospective analysis of data from 3109 users with multiple types of chronic musculoskeletal pain. The findings showed that engaging with the SimpleTherapy program was associated with a significant decrease in pain intensity and significant improvements in self-reported quality of life and work life. These outcomes are comparable to traditional physical therapy results without requiring any additional equipment like motion tracking devices.</p><h3 class="wp-block-heading" id="The-study's-key-findings-include-the-following:">The study's key findings include the following:</h3><ol><li><strong>A significant decrease in pain intensity:</strong> Users reported a clinically significant decrease in pain intensity of 2.09-point points on a pain Visual Analogue Scale by the 11th session.</li><li><strong>Significant improvements in quality of life and work life: </strong>The study found that using the SimpleTherapy program was associated with significant improvements in self-reported percent improvement in participants' quality of life and work life.</li><li><strong>High levels of engagement: </strong>46% of participants were performing more than one session per day, 70% were doing two sessions within two days of onboarding, and 88% were engaging within a week of onboarding.</li><li><strong>Scalability and wide-ranging disease applicability: </strong>The study included a large number of participants and multiple pain sites, demonstrating the potential for the SimpleTherapy program to be applied across various conditions without the need for sensors or motion-tracking devices. Users with pain in various body parts, such as the lower back, upper back, neck, ankle, foot, wrist, hand, hip, and knee, experienced benefits without the need for motion-tracking devices or computer vision technology.</li></ol><h3 class="wp-block-heading" id="Evidence-Based-Approach-without-Motion-Tracking-Devices:">Evidence-Based Approach without Motion Tracking Devices</h3><p>These findings provide foundational evidence that SimpleTherapy programs can offer similar benefits to traditional physical therapy but with the added advantages of high levels of patient compliance with prescribed care and enhanced accessibility. Our platform eliminates the need for expensive, hi-tech setups like motion sensor or computer vision technology, making it more convenient and cost-effective for users seeking pain relief and rehabilitation.</p><p>By demonstrating that motion-tracking devices aren't necessary for effective physical therapy, this study further solidifies SimpleTherapy's commitment to delivering evidence-based, virtual therapy services that are both effective and accessible.</p><p>SimpleTherapy focuses on delivering virtual therapy services that are supported by scientific research. Our platform provides personalized exercise therapy programs that have been shown to be effective in reducing pain and improving function for individuals with MSK conditions <sup>(2)</sup>. Furthermore, a study published in the Journal of Telemedicine and Telecare found that virtual rehabilitation without motion-tracking devices can lead to similar outcomes as traditional in-person therapy, including pain reduction and functional improvements <sup>(3)</sup>.</p><h3 class="wp-block-heading" id="Promoting-Health-Equity-and-Diversity:">Promoting Health Equity and Diversity:</h3><p>By eliminating the need for motion-tracking devices and providing virtual therapy services that are both effective and accessible, SimpleTherapy actively supports health equity and diversity. Without additional hardware, our platform can be accessed from any device with an internet connection, making it more convenient for users seeking pain relief and rehabilitation; and cost-effective for employers looking to bring a solution that supports health equity without breaking the bank. Our platform allows individuals from various socioeconomic backgrounds, including those with limited access to traditional physical therapy services, to receive high-quality care that can improve their lives.</p><p>SimpleTherapy's commitment to health equity and diversity extends beyond offering an accessible platform. We also prioritize hiring diverse healthcare professionals to ensure our users receive culturally sensitive care that caters to their unique needs.</p><h3 class="wp-block-heading" id="Conclusion:">Conclusion:</h3><p>SimpleTherapy is committed to delivering evidence-based, digital, and virtual therapy services that are both effective and accessible. SimpleTherapy's clinical study with Mt. Sinai provides compelling evidence that motion-tracking devices are not required for effective physical therapy. Our platform offers personalized home-based exercise therapy programs for people with chronic pain, can achieve significant pain reduction and improved quality of life without relying on additional hardware. This approach enables us to provide a more accessible, affordable, and user-friendly solution for individuals seeking pain relief and rehabilitation.</p><p>By prioritizing research-backed methods and focusing on user engagement, delivering high-quality virtual therapy, SimpleTherapy is committed to positively impacting the lives of those living with chronic pain, without the need for motion-tracking devices. By making our services accessible and affordable, we aim to improve people's lives with chronic pain through evidence-based, personalized home-based exercise therapy programs.</p><p></p><p class="has-small-font-size">References:</p><ol><li class="has-small-font-size">Lund, H., Juhl, C., Nørgaard, B., &amp; Christensen, R. (2018). Movement Sensors for Effect Estimation in Patients with Musculoskeletal Disorders: A Systematic Review of the Literature. Journal of Medical Internet Research, 20(5), e197. <a href="https://doi.org/10.2196/jmir.9973"><u>https://doi.org/10.2196/jmir.9973</u></a></li><li class="has-small-font-size">Kim T, Gay N, Khemka A, Garino J. Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial<br>JMIR Rehabil Assist Technol 2016;3(2):e12 <a href="https://doi.org/10.2196/rehab.5148">Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial</a></li><li class="has-small-font-size">Delgado, Andrew Dean1; Salazar, Sophia Isela1; Rozaieski, Kendal2; Putrino, David1; Tabacof, Laura1. Engagement in an mHealth guided exercise therapy program is associated with reductions in chronic musculoskeletal pain. American Journal of Physical Medicine &amp; Rehabilitation ():10.1097/PHM.0000000000002257, March 31, 2023. | DOI: 10.1097/PHM.0000000000002257</li><li class="has-small-font-size">Cottrell, M. A., Galea, O. A., O'Leary, S. P., Hill, A. J., &amp; Russell, T. G. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Journal of Telemedicine and Telecare, 23(5), 557-564. <a href="https://doi.org/10.1177/1357633X16649531">https://doi.org/10.1177/1357633X16649531</a></li></ol>

The Science Behind SimpleTherapy: Why We Don't Use Motion Tracking Devices

<p><div id="bp-page-1" class="page" data-page-number="1" data-loaded="true"></p><p><div></div></p><p><div class="textLayer">According to Oxford Dictionaries, the definition of ambivalence is the state of having mixed feelings or contradictory ideas about something or someone else. Are you still on the fence about making a change or starting something new? You are not alone. This is human nature. We tend to want things to happen simultaneously that can’t co-exist. Look at these pain predicaments:</div></p><p><div></div></p><p><ul></p><p> 	<li>Being sedentary can cause muscles to be stiff but Carl’s muscles have been stiff for so long that it hurts to move them and now he is scared to give a new flexibility program a shot.</li></p><p></ul></p><p>&nbsp;</p><p><ul></p><p> 	<li>Bob has been working on cutting empty calories out of his diet because he carries some extra weight which has led to low back pain for the past 5 years. However, his coworkers always bring in sweets and leave them out in the break room, so he has the urge to indulge.</li></p><p></ul></p><p></div></p><p><div id="bp-page-1" class="page" data-page-number="1" data-loaded="true"></p><p></p><p>&nbsp;</p><p></p><p>These feelings can bring on anxiety, cause you to freeze, and leave you not wanting to change. It can feel like a never-ending cycle of wanting to change one day and waking up the next thinking,“I’ve made it this far, why to change now?”</p><p></p><p>Does this sound familiar? If so, you may not have the right “why” for making a change. Ask yourself “why” it is that you truly want to make the change you are ambivalent about. What does the result look like? Is it internally driven or motivated by external factors?</p><h4>Internally driven goal or “why”:</h4><p>I want to manage my pain so I can live my life pain-free and enjoy an active retirement so I do not have to be wheelchair-bound and take prescription medication daily to manage my pain.</p><h4>Externally driven goal or “why”:</h4><p>My spouse wants me to manage my pain because they tell me I complain about it too much so they signed me up for this program. One of these people is more likely to accomplish their goal and want to make a lasting change for themselves. Can you guess which one it is? Hopefully, you chose the internally driven goal! If not, that’s okay and we can help!</p><p></p><p>Changing behaviors takes time and is a revolving process without a linear path. There will be good and bad days and we will all be ambivalent at some point in time. Maybe you can’t think of a good “why” or you are starting to lose faith that you can accomplish what you initially set out to do. Maybe your goal isn’t going as expected or you aren’t seeing results in the timeframe you hoped to initially. This is all completely normal and why you have a SimpleTherapy care team to support you on your journey.</p><p></p><p></div></p><p><div id="bp-page-2" class="page" data-page-number="2" data-loaded="true"></p><p><div class="ba-Layer ba-Layer--regionCreation" data-resin-fileid="861240284144" data-resin-iscurrent="true" data-resin-feature="annotations" data-testid="ba-Layer--regionCreation"></p><p><div class="ba-RegionCreation-creator ba-RegionCreator" role="presentation" data-testid="ba-RegionCreator"></div></p><p></div></p><p><div class="textLayer">If you are feeling ambivalent but are ready to make a change, schedule a call with your health coach today so you can talk through your “why.” We are here to listen!</div></p><p></div></p>

Overcoming Ambivalence: Finding your Right 'Why' for Making a Change

<h4 data-renderer-start-pos="69">What is SMR Technique?</h4><p data-renderer-start-pos="72">Self-myofascial release is a safe and easy technique. It utilizes your own body weight and minimal tools to increase flexibility and muscle recovery. Objects such as foam rollers, lacrosse balls, tennis balls, or massage balls can be applied to the designated area. The application breaks up muscle adhesions, increases muscle tissue flexibility, and helps flush out toxins and stale blood. The level of soreness and area of the body often determine the most appropriate tool that should be used. You can also use your own bodyweight to dictate the amount of force applied to the area. More stubborn and painful adhesions may or may not require an increase in applied pressure. Adhesions that are left untreated can often turn into trigger points or knots. Trigger points can cause constant discomfort, impair mobility, and create muscular asymmetry. If a particular muscle feels super sore, hop on a foam roller!</p><p data-renderer-start-pos="767"><a href="/uploads/2021/03/Foam-Rolling-Equipment-STOCK-PHOTO.webp"><img class="wp-image-3674 aligncenter" src="/uploads/2021/03/Foam-Rolling-Equipment-STOCK-PHOTO.webp" alt="" width="488" height="327" /></a></p><h4 data-renderer-start-pos="790">When is the Best Time to Use SMR?</h4><p data-renderer-start-pos="793">SMR technique can be utilized before physical activity, after physical activity, or even on a recovery day. Prior to physical activity, SMR allows for an increase in tissue function. It helps the muscle to lengthen easier during dynamic movement and can greatly improve the effectiveness of a warmup. The applied pressure will break up muscle adhesions and improve elasticity in the soft tissues.</p><p data-renderer-start-pos="793">Muscle adhesions are damaged muscle tissues that have not fully healed. Adhesions often need additional assistance in the recovery process. These can commonly occur after a tough game, intense workout, due to frequent repetitive motions, or any time the muscle fibers have been damaged. The same process can be done post-workout to restore normal muscle and joint function as well as flush out lactic acid and other toxins that may have accumulated during the bout of physical activity.</p><h4 data-renderer-start-pos="1653">How to Navigate</h4><p data-renderer-start-pos="1653">Initially, discomfort in the targeted area might be intense but, you should be able to adjust the pressure accordingly. You should apply maximum tolerable pressure in order to achieve the most benefits. This is a great supplement to all kinds of physical activity to help facilitate recovery and help the body transition from states of inactivity and activity.</p><p data-renderer-start-pos="1653"></p>

Surgery is Not Always the Best Option

Suggested Resources