The Future Adjustment Podcast Episode 19: State of biomechanical assessments

Chiropractic Economics-The Future Adjustment Podcast

Daniel: Welcome to “The Future Adjustment,” Chiropractic Economics podcast series on what’s new and notable in the world of chiropractic. I’m Daniel Sosnoski, the editor-in-chief of “Chiropractic Economics,” and our guest today is Ryan Comeau, DC. He’s the CEO and Co-Founder of Kinetisense, a technology and software firm that’s been gaining significant attention. And you may have seen their Parker 3D Booth at this year’s Parker Seminars Las Vegas 2018 conference. Dr. Comeau is a graduate of Southern California University of Health Sciences, where during his studies, he realized the need for more objective and precise movement and analysis tools.

Dr. Comeau, thank you for joining us today. To set the stage, can you tell us a little bit about the state of biomechanical assessment as you saw it prior to the founding of Kinetisense?

Dr. Comeau: Absolutely. And Daniel, I’d like to thank you for having me on this podcast, it’s truly an honor. Currently, the state of biomechanical assessment in the clinical setting is really one of subjectivity and the lack of efficiency.

We find that, in the clinical setting, we really do lack the tools to be able to gather proper information on our patients and to be able to see progress that we make as practitioners. And what happens is this leads to, obviously, a subjectivity in assessment where we’re often left with having to eyeball the patient or having to have difficulties with looking at their progression over time.

The other issue that we see is a lack of efficiency. Many of the tools that we do have require having to put on wearable systems or require extra time of the practitioner with the patient. And in a clinical setting, this can be very, very difficult for the practitioner. And oftentimes, practitioners will get caught in this tradeoff between the efficiency and the objectivity and choose to simply eyeball their assessments or use some of the more archaic tools that we’ve had in our profession for hundreds of years, like the goniometer and inclinometer.

And really, this results in the patient satisfaction being affected. This results in patient compliance being affected, as the patient really is not engaged in the process of the assessment and in the process of rehabilitation. The patient is not able to see the changes that we’re making, the powerful changes that we make as practitioners with adjustments with the different clinical tools that we use.

The other important thing too is the ability to collect data to be able to make our practitioners movement scientists. This is a very important concept because when we start to look at, as a profession even, the changes that the adjustment makes to the neuromuscular system, neuromusculoskeletal system, we’re able to now see which techniques, which different modalities are making the best changes for the different symptoms or issues that our patient has.

The other advantage of this is that we can expand one’s clinic walls, we can expand the practitioner’s walls of their clinic and allow them to have a portable tool that they can go out in the community and really showcase chiropractic to the masses.

Daniel: Right. Okay, let me pause right here. For listeners who aren’t familiar with what Kinetisense is about, let’s dial in and describe it a little bit, because when we’re talking about range-of-motion measurement, posture measurement, any kind of biomechanical measurement, there’s really two paradigms that we have in the chiropractic space.

First, we have the really old-school analog tools. Like if you’re gonna measure, you know, how far an elbow can bend, you have something that basically looks like a mechanical protractor and, you know, you basically just dial in the angle that you’re registering and you write that down on the intake form.

And then you have a newer wave of tools that are often handheld and Bluetooth. And they have, you know, motion sensors, and those transmit to a computer screen, and you can get fairly good readings off of that.

Kinetisense is like going off way into the third dimension in the future using a device…I think, right now it’s based off the Microsoft Kinect system, is that right?

Dr. Comeau: Yeah that’s correct.

Daniel: Right. And so, it’s a series of intelligent cameras that actually focuses on the patient, and it basically can just read and assess their movement completely through software, and records that data directly to a computer, and gives you readouts.

Dr. Comeau: Correct.

Daniel: Right. And this company, your company, you founded it back in 2012. Can you tell me, kind of, like, what…You’ve described it as being the first markerless motion capture analysis system. Can you explain your thinking and what that means?

Dr. Comeau: Yeah, absolutely. Yes. So, definitely, you know, with these other systems that you’ve mentioned, you know, if you’re looking at, let’s say, range-of-motion with the handheld tools that we have. This involves having the practitioner, you know, placing these tools on the body, which really does have an effect on the overall motion of the patient. But also, when we’re looking at assessing joints, let’s say we’re assessing a shoulder and abduction, for instance. The body can compensate, and the other joints of the body can compensate. Sometimes the patient will go into a little bit of a lean or sometimes the patient will rotate slightly.

The beautiful thing about Kinetisense is with the 3D motion camera that does not require wearables, it simply picks up the joints automatically, reproducibly every single time, we can get true joint values. And that’s a very important concept because let’s say, you know, in assessing shoulder abduction, if the patient does lean, the system will automatically calculate that lean into the range-of-motion of the shoulder. So we’re getting pure joint range-of-motion, specifically of that joint, because the algorithms will remove any other motions of any other joints of the body or any other joint planes of the body. So this becomes the most accurate joint assessment that we have and the joint, obviously, just being one of our modules.

And so, with the camera, and this is, it’s the Kinect camera, you’re correct, this camera is able to locate the joints of the body based on three different systems that it has built within. So, one of those being the ability to pick up infrared, so the heat distribution of the body. There’s also a sonar component which picks up depth, and this does a topographical representation of the body line for the reproducible placing of the joints, and also gives us the transverse view, the overhead view. So we’re able to look at compensation patterns of movement in all three planes. We have the frontal view, we have the sagittal view, and then we also have the transverse view. So we can look at compensation, we can look at muscle firing patterns that occur with all the different ranges of motion.

And then the system will automatically take this data and write it out into SOAP note form for our practitioners, so they can simply API that into their charting, they can copy and paste that into their charting, saving the practitioner even more time.

Daniel: Well, that’s really amazing. And when I attended Parker Seminars earlier this year, I was able to take a demonstration of the system myself and it was amazing. All I had to do was just walk in front of the Kinetisense unit, and immediately, it was tracking me, it was placing points of measurement automatically on my body. And the person at the booth who was demonstrating the system just asked me to turn 90 degrees and raise my arm. And it was all happening in real-time.

There’s been talk about the future of healthcare intersecting with augmented reality, and it’s no longer in the future, you’ve actually brought that to us right here, right now, and it’s immediately available.

You mentioned modules. In addition to Range-of-Motion, for example, how far an arm or how far a person can bend over with their torso, what other modules are available with Kinetisense?

Dr. Comeau: Yes. So, Kinetisense is a module-based system. And really, when we started Kinetisense back in 2014, the first module that we developed was Range-of-Motion. So, being able to replace, you know, systems like the goniometer, inclinometer, and being able to do joint by joint assessment. With our technology, with the Range-of-Motion component, we’re able to do assessments such as cervical rotation, different rotations in a standing position. So, being able to really get insight as to what’s happening with the muscles in that support of position.

We then transitioned into posture, and we created 3D Posture. And 3D Posture is the only system in the world that gives the transverse view, that overhead view of assessment with a single front-facing camera.

We then progressed into 3D Balance, 3D Balance Assessment, where there’s no need to have a balance platform. And what it does is it actually will calculate the amount of sway that occurs at each segment of the body, unlike a force plate that only gives you information on the foot. So we’re able to figure out what part of the body is lacking proprioceptive input or stability, whether it’s the hip, the knee, the shoulder, and exactly in what plane.

We then moved into the 3D Functional Movement component. So this is a movement module where you can do any type of movement, whether it’s a golf swing or whether you want someone to do a box jump or have someone reach overhead. And it calculates all of the joints of the body in real-time, and the practitioner can take data captures of the video of the patient doing whatever movement they’re going through.

We then transitioned into what is called as KAMS. And this was the product that we launched at the Parker Seminars in Vegas. And we’re very, very excited about this module because KAMS is a workflow of 12 different movements that are science-based movements, that give insight into compensations of the body. So, movements such as the overhead squat, the inline lunge, we do a modification of posture with the posture software.

And this system will calculate all the different data points and find the compensations and which joints, which planes are rotating or shifting, or how that patient is trying to find ways to accommodate the movement and whether it’s efficient, and actually scores their function, which is a huge change to what is currently being done with some of the more visual functional movement assessments that we have that take, can take 20 to 30 minutes. This is done in three minutes, and automatically is reported. So, very excited about that.

Daniel: Yeah, we’re talking right now about measurements, but I understand that because, you know, what you’re describing right now is dynamic movement, you’re not simply, you know, measuring a single action but you can actually look at the body in motion and make some assessments from that. And I understand this can also be used for risk analysis?

Dr. Comeau: Yeah, that’s correct. So, with the modules and specifically with Balance, for instance, our Balance module is being used in concussion baselining, and then reassessment after a concussion. So it’s being used by a bunch of different sports organizations, professional teams, for that. Also, risk of fall in the geriatric population.

We’re actually able to look at the numbers, you know, that we get from balance. We’re actually able to look at trends with our patients and see if they’re trending in a positive way or a negative way and be able to get insight as to, “Okay, when is it time to intervene? You know, what changes do we have to make to prevent further injury to occur?”

We’re also doing this with KAMS, so our functional movement screen where we’re starting to work with different universities with research looking at, “Okay, what is the amount of injury that a volleyball player will have over the course of a season or a team? And how does assessment and intervention before injury occur? How well does that work?” And we’re getting some very promising results early on. So, being able to assess risk of injury really is at the forefront of what we’re doing with the data capture.

Daniel: Yeah. Although on this podcast, we don’t often go into proprietary technology and patented items, we’re definitely making an exception today, because it’s definitely our assessment that Kinetisense isn’t simply a tool, but it allows the practitioner to open new doorways into new types of practice. And you’ve made things possible that have simply not been possible in the past. It’s a real game changer. And, I think, really, the best way for our listeners to understand what a game changer this is is to take a look at it themselves. How can people see Kinetisense in action? Is there a place they can go online?

Dr. Comeau: Absolutely, yeah. The best place for the listeners to get more information on Kinetisense would be to go to our website, that’s www.kinetisense.com. And, on the website, we have a lot of different information there on the different modules, the different groups that are using the product. And then, on our website, you can actually book an online demo, a free online demo, with our team. And our sales team and our kinesiology team will take you through every single step of the product to be able to, you know, learn some more information about the clinic that you have, and not only, you know, how to integrate, but different strategies on how you can use the system both in your clinic and in your community.

Daniel: Well, we’ll have a link to that directly on this web page, and I urge anybody with interest to take a look at it.

Dr. Comeau, you have been a font of information this morning and I wanna thank you for being with me today.

And the emerging technologies in the realm of augmented reality always have just seemed to be around the corner, but you’ve made them available for practitioners to use right now, and for that we’re thankful. And thank you, for giving us a three-dimensional look at the future adjustment.

I’m Daniel Sosnoski, and we’ll see you next time.

The post The Future Adjustment Podcast Episode 19: State of biomechanical assessments appeared first on Chiropractic Economics.