The last mile: measuring movement that matters in environments that matter.
Let me start with a disclaimer. I’m not a coach, physical therapist, athletic trainer or any other type of healthcare professional. I’m a designer and product guy who has been lucky enough to work in the field of biomechanics and sport science for the better part of 10 years.
I’ve been fortunate to work with, and see inside, many of the top professional sport organizations in the world (including all major leagues in North America). I’ve worked with various sports medicine and orthopaedic rehab clinics, as well as in hospitals and with elite military operational units. With each group, I have supported the health and performance staff in managing the injuries and general health of their population using the Plantiga system.
The Blind Spot
Across the board I’ve seen the same problem over and over: practitioners struggle to quantify what’s happening to their patient or athlete when they perform in the real-world. Be that during a game on the court or on the field, how they perform during their favourite trail run or something as simple as how they walk around the block after dinner, practitioners don’t often truly see (with objective data) how someone functions in the real world.
At the end of the day, a practitioner is trying to figure out how a person is doing (progressing, regressing or sometimes just maintaining) and if there are trainable deficits that can be addressed with exercise and treatment.
The standard of practice for most practitioners when assessing function in the real world is to visually inspect how their patient or athlete moves in that environment. However, it’s impossible to quantify a person’s biomechanics and movement patterns with the naked eye. And in fact, studies have shown time and time again that a practitioner’s ‘gut’ or ‘feel’ or ‘eye’ is often as good as guessing.
In deciding if a person is ready to go back to work, sport, whatever, a physical therapist will watch them move. On top of that, and depending on the injury, they’ll run them through certain competency tests like jumping or changing direction. This is necessary but doesn’t the tell the whole picture.
Gaps In Treatment
Here’s a good example of what I mean. Imagine a high school female soccer player is getting ready to return to competitive play after coming back from ACL reconstruction surgery.
Her physical therapist might eyeball her performance during a scrimmage or on-field training, but as this isn’t enough, the standard of practice with all ACL rehabs is to run them through a series of tests (tests like the triple leg hop and T test) with the aim of passing or failing the athlete — much like a high school exam. From what I’ve seen, there’s no way a single set of tests is sufficient as a clearance tool. The current understanding now is that these tests do a pretty poor job if re-injury is any indication.
The problem with this testing is it will never be able to recreate the forces of jumping, cutting, or sprinting and stopping on a dime that occur in an actual game. She will move differently when it’s for real, or when a game is at stake.
This is what’s called the Hawthorne effect: when a person’s behaviour (in this case, their movement) is affected by their awareness of being observed. In order to combat this effect, we need objective data to fill in the gaps for where it matters most — on the field, when movements are most natural.
This doesn’t just apply to a rehabbing youth athlete. This is the same for somebody going to work, getting cleared to pick up their child or go on long walks or runs. We need to be assessing a person with objective data collected from real-world situations.
Frankly speaking, most practitioners have no idea how their population moves in terms of their normal patterns; how they walk, how they jump, how they run, how they move about during the day, and that’s what we’re here to support.
Now imagine that the high school athlete above is wearing sensor insoles that measure not just a battery of tests, but how she’s jumping, sprinting, stopping and cutting in a real game. One step further, imagine if we have baseline or pre-injury game data. Now a practitioner knows the healthy bandwidth for specific parameters and uses them to determine if she’s ready.
Same goes for a care aid at an old age care home. Imagine if we knew how she walked normally and then used that to assess if she was ready to go back to work after hurting her back on the job.
Can’t Manage What You Don’t Measure
You can’t manage what you don’t measure. That statement is something we hang our hat on. Practitioners have a variety of powerful tools inside a gait or performance lab that are designed to analyze how the lower body moves, but the second a person leaves the lab all bets are off. Measuring this stuff in a controlled lab setting is completely different than measuring in the real world. That’s the blind spot, and the gap.
This is not for a lack of trying. There are a number of groups trying to get real-world biomechanical data by using cameras or placing sensors on a person’s back, ankle, tibia or somewhere else on the body. The main problem is that any sensor that goes on the body will be noisy. There are a lot of issues surrounding time sync, drift, battery, longevity, calibration, and connectivity to deal with. Doing this is crazy challenging. I commend any group or person working on this; working at measuring the things that matter in the environments that matter.
With Plantiga, we’ve managed to address the countless technical issues in getting reliable real-world data but it’s been an undertaking that’s taken several years to get right. With our platform reliable in both technical terms and in the validity of our metrics, we are now starting to see the compounding value of collecting this data over time on numerous patients and athletes.
Most groups I interact with want to be data-driven, but first you need a way to collect the data, understand what it means, and then use it to help drive that decision making. Plantiga can help.
I’m excited as the use of our platform is coming into its 2nd year with many of our customers, and the proof is now in the pudding. We’ve tracked various people over 18 months, often throughout the rehab of several injuries.
Now that these practitioners are collecting, tracking and monitoring core movements in environments that matter, and over months and now years, the power of the data is really starting to take shape — from managing injuries to assessing performance and overall health.
Filling In The Gap
Plantiga has started as a practitioner’s tool but very soon here we want to be offering the platform to individuals so they can track and monitor their own health. That has always been the goal and is important to me and our team.
If you are a practitioner, any type of healthcare professional or just an individual interested in your health and wellness, I would love to hear from you. And I mean it. Give me a shout at firstname.lastname@example.org. We’re just getting started.
Entrepreneur, designer, data wrangler and musician. Building @plantiga. Fortunate to call Earth home.