Healthline: Stretching May Help Slow Cognitive Decline as Well as Aerobic Exercise

Written by Beth Ann Mayer

Simple movement, including regular stretching, balance, and range of motion exercises, might be just as effective in slowing mild cognitive decline as aerobic exercises.

It may sound like a stretch, but new research suggests it’s science. Researchers presented the data at the 2022 Alzheimer’s Association International Conference in San Diego on Aug. 2.

To perform the study, they followed 296 sedentary older adults already diagnosed with mild cognitive impairment (MCI). This condition can lead to Alzheimer’s Disease, though it’s not a given.

Half of the participants were instructed to do aerobic exercises on treadmills and stationary bikes at a moderate intensity of about 120 heartbeats per minute for 30 to 40 minutes. The rest were told to perform functional stretching, balance, and range of motion exercises. The groups worked with a personal trainer twice per week and alone on two additional days for a year.

MedCity News: CMS’s Newly Released Remote Therapeutic Monitoring Codes Allow Providers to Bill for Digital Health, but Only if Payers Adopt Them

By Sean Kinsman

Early this year, the Centers for Medicare & Medicaid Services released a group of new reimbursement codes that have the potential to catapult digital health solutions for musculoskeletal (MSK) and respiratory care to the next level.

Providers are now able to bill payers using Remote Therapeutic Monitoring codes, or RTM, for digital MSK or respiratory services related to the cost, set-up, and monitoring of software and devices that measure patient therapy adherence and therapy response. For providers who have been impacted by pandemic-related burnout and staffing shortages, these codes now provide the financial structure and incentive to scale digital treatments and therapies for their patients who suffer from MSK or respiratory problems. MSK conditions alone are a huge driver of US healthcare spending and disability with one out of two people impacted by an MSK-related issue.

Mobihealthnews: Seniors Aren’t Tech-Averse. We’re Just Not Designing for Their Needs.

By Mark Luck Olson

Seniors are certainly less tech-savvy than younger generations who grew up with it. My parents are from the World War II generation, long before there was the personal computer, let alone the internet. Trying to help my aging mother with email is a challenge. But just because some may not know how to use TikTok, what a nonfungible token is or how to make the WiFi work doesn’t mean they are technology averse.

MedCityNews: Have back, hip or knee pain? What to consider before seeing an orthopedic surgeon

MedCityNews | By Dr. Alan Daniels, April 6th, 2022

As an orthopedic spine surgeon who performs approximately 500 surgeries a year, my favorite type of patient is the one I never have to see—not even once. The reason for this is that means their musculoskeletal (MSK) issues—any condition or injury affecting joint, bone, tendon or muscle—haven’t progressed to the point where they need to consult with a surgeon.

To put it bluntly, surgery is not always the best answer. Surgery is invasive, expensive and sometimes risky. Often behavior modifications that help with losing weight and increasing mobility, such as exercise, stretching and eating healthily or physical therapy, can successfully address many MSK issues, while at the same time reducing healthcare spending. For example, when physical therapy is the first line of treatment, according to a systematic review in the Physical Therapy & Rehabilitation Journal, it results in lower overall healthcare costs, fewer visits to the doctor and better patient mobility.

Mobi Health News: Digital musculoskeletal care is booming. Where does the market go from here?

Mobi Health News | By Emily Olsen, February 04, 2022

Musculoskeletal care is a big problem for the U.S. healthcare system, digital health companies say. Disorders are common and expensive to treat, but care that could cut down those high costs is inaccessible to many who need it.

That message is resonating with investors. Over the past year, they’ve poured hundreds of millions of dollars into the digital MSK space. Unicorns Hinge Health and SWORD health both closed multiple rounds of funding in 2021, some worth nine figures

But they weren’t the only companies competing for venture dollars: Kaia HealthRecoveryOne and SpineZone also raked in millions of dollars in deals last year. Meanwhile, DarioHealth, which also offers tools for managing chronic conditions like hypertension and diabetes, bought its way into the space by acquiring Upright Technologies. It announced the launch of its MSK platform, called Dario Move, in October. 

RecoveryOne stakes claim in Medicare Advantage: Providing access for Seniors most in need of virtual MSK solutions

If you scan the digital health scene for companies that deliver virtual physical therapies for musculoskeletal (MSK) conditions to the senior population, you likely won’t find any. Yet, if you look at the sheer number of people with MSK problems, half of them are on a Medicare plan.

What’s the disconnect? The simple answer, partnering with a health plan serving Medicare customers is time-consuming and difficult. It’s not as easy as signing up a self-insured commercial customer, which is what other digital MSK health companies target.

That’s why we have expanded our partnership with Cigna to offer virtual physical therapy and a broad MSK solution to Medicare Advantage customers. It’s a strategic collaboration that has allowed us to make a real stake in Medicare by offering RecoveryOne’s solution to treat MSK conditions and injuries as an in-network benefit.

Our platform is currently available to Cigna Medicare Advantage customers within the Tennessee market, which includes plans in North Mississippi, Virginia and North Georgia, with the intention to expand to many other markets.

At RecoveryOne, we don’t shy away from challenges or hard sells. We are invested in our customers and make every effort to ensure all of their members have access to our MSK platform. In fact, RecoveryOne was founded originally to support total hip and total knee populations. It was our bread and butter in the early days and a meaningful proportion of those customers was in the 65 and older crowd. While we have improved our offering since then to be a comprehensive solution for all back and joint problems, we haven’t forgotten our roots and continue to support seniors.

The need for MSK solutions aimed at the senior population
Nearly three out of four people age 65 and over in the United States are affected by MSK ailments, most commonly damage caused by osteoarthritis and fall-related injuries. Yet, the MSK digital health industry is focused on self-insured employers, not Medicare-managed health plans, which cuts out a huge swath of the senior population, the ones who would benefit most from it. In some instances, digital health companies who contract with self-insured employers end up with older customers through the company retirement benefits program. But that’s almost by accident and makes up a marginal slice of the Medicare pie. We purposefully aim to help and support seniors.

RecoveryOne saw a need to expand digital programming to a vulnerable population. With Covid, it is even more important to offer virtual service so seniors don’t have to venture out into the pandemic and risk exposure. 

From the comforts of their home, seniors meet virtually with a physical therapist for an initial assessment. The appointment is with a real person, not a bot. Based on the unique factors for the individual, the therapist chooses one of our 200 clinically proven pathways that includes exercises to reduce pain and improve recovery. Every customer also receives a personal health coach who connects with them regularly to motivate and answer questions via messaging. To keep it simple, we don’t bother with sensors, they are bulky and annoying to wear during exercises.


Historically, most people don’t finish their in-person physical therapy, mainly because it’s a hassle. With RecoveryOne, it’s not a chore. It’s simply convenient and effective. And our health coaches are there to support seniors along the way.

 

Debunking the Myth Old People are Tech-Averse
The question I most often get asked about serving the Medicare population is “Aren’t seniors tech-averse?” I mistakenly assumed the same years ago. I’m relieved to know I was wrong.  So, let’s debunk it.

The vast majority of older people have smartphones. Grandparents today regularly use their phones to video chat with their grandchildren and post on Facebook. Today, smartphone adoption is 86% for 50 to 59 and 81% for those 60 to 69, with 62% of those 70 and older using smartphones. And that’s all you need to access our MSK solution.

On our platform, I’ve been pleasantly educated to see a senior population’s high level of comfort with our technology. Seniors surely aren’t as tech-savvy as the Gen Z population, but they are more than capable of accessing and navigating RecoveryOne. And just because they aren’t digital natives doesn’t mean they shouldn’t get access to digital health solutions.

A Scalable Solution for Seniors that Saves Money

Working with Cigna’s Medicare Advantage customers is a scalable, cost-effective solution for helping heal seniors with MSK injuries. 

Because Medicare Advantage customers don’t have to leave their homes or wait weeks for an available in-person appointment, they save money, time and energy not having to travel or pay for expensive gym memberships.

RecoveryOne saves health plans money. Based on national claims data from more than 350,000 members, RecoveryOne reduced the total medical cost by $751 per member per month for MSK-related diagnoses and reduced costs by nearly 77% for low back pain and 84% for rotator cuff tears.

So while the MSK digital health industry may appear crowded, it actually fails to address the senior consumer population. That’s a massive missed opportunity. Let’s help those who need virtual care most heal from their injuries or surgeries. Now that RecoveryOne’s solution is available to Medicare Advantage customers, there is work to be done to expand even further and improve our product even more.

Calming your mind and body

Pain helped early humans survive. When they felt pain, they saw it as a threat they needed to escape quickly. When you’re always in pain, though, your “high alert” system remains on for too long. You feel stressed and your muscles stay tense, which ends up making your pain even worse. Learning to calm your mind can help you reduce pain.

There are three ways to calm your mind: breathing slowly, being mindful, and using imagery. Though you can do these things almost anywhere, anytime, it can be helpful to set up a schedule to practice them. You could even do a short breathing, mindfulness, or imagery practice before or after your RecoveryOne exercise session. The better you get at calming your mind, the less tension and pain you’ll feel.

Slow, deep breathing is something that can help you relax quickly, and you can do it almost anywhere. All you have to do is breathe in through your nose for two counts and out through your mouth for four counts. Breathe deeply while keeping your chest and shoulders stable. Repeat this a few times and notice how it makes you feel.

Being mindful — you’ve probably heard of it as “mindfulness” — is not as complex as it sounds. It means being aware of your senses, thoughts, and feelings in the present moment, as they happen. To practice mindfulness, sit or lie down, close your eyes, and notice your thoughts. Do your best not to judge or analyze them; let them float away like clouds. Try setting a timer to practice for two or three minutes each day, and increase the time as you get better.

One more tactic to relax your mind and body is to use imagery, or to picture yourself in a calm place. Sit or lie down, close your eyes, and imagine a time or place that makes you feel at peace. This tactic works best when you use all of your senses. How does it feel to be in this place? What can you hear, see, smell, and taste? If you need some ideas, picture yourself lying on a warm beach, walking in a peaceful rainforest, swimming in a balmy pool, or taking a tranquil bubble bath. Learning to calm your mind and body can lessen the impact of stress and help with pain. Slow breathing, being mindful, and using imagery are simple methods that you can add to your daily routine. Your body will thank you for the small efforts you make to deal with stress.

Low back pain: Everyone’s getting it!

Have you ever had low back pain? Odds are, you have. Per the World Health Organization (WHO), 60 to 70 percent of people in high-income countries will have low back pain at least once in their lives. There are many causes for low back pain, so you should always consult with your doctor to make sure it’s nothing serious. That said, there are many things you can do to better understand your pain and work to relieve it.

To start, try to notice what caused or causes your pain and what your symptoms are. Your acute (sudden and short-lasting) low back pain could be linked to poor posture; sleeping oddly; or soreness that lingers after you do too much yardwork, pilates, or other intense activity. With low back pain from these causes, your back muscles might feel tight and tender to the touch. You could also have pain when you move in a certain way or stay in the same position for too long. You may have soreness in your hip or leg, decreased motion on one side, leg weakness with long periods of movement, or pain that affects your sleep. Your symptoms can be on one or both sides.

When you observe your symptoms, look out for any signs that mean you should seek medical care ASAP. These could be signs of something deeper than simple soreness, like nerve damage. Here are some red flags that may come with low back pain:

  • Numbness or tingling in your leg
  • Weakness in your leg that doesn’t come from prolonged movement
  • Your leg gives way while walking
  • Shooting, electric, or gnawing pain that goes down your leg
  • Pain that is constant and/or severe

Now for the best part: what to expect as you get better! Sometimes, back pain can go away on its own if you rest and avoid things that make your symptoms worse. Often, though, it takes special treatments to get better. These treatments include:

  • Using ice or heat
  • Putting on creams that numb your skin or reduce inflammation
  • Massage

Hear what others have to say about RecoveryOne.

The key to getting better from low back pain is physical therapy (PT). PT exercises that address stretching and strength are the base of recovery. When you do your PT exercises, do them with focus and good form. Also, be sure to keep doing PT exercises, even when you start to feel less pain. Though you might not think you need to, you should complete the full course of treatment to avoid getting hurt again. You may also need to switch up the types of activities you do for the short or long term to reduce symptoms and prevent reinjury.

You might wonder how long it’s going to take to recover. This can vary: sometimes, it can be a day or two. When pain sticks around, your recovery could take a couple of weeks to a few months. This process includes using the treatments we mentioned above. With a more serious issue, it could take you more than six months to get better, and you might need surgery. Make sure to follow up with a doctor if you’re having low back pain that doesn’t go away.

You’re not alone if you’re having low back pain. Though your symptoms may make you feel annoyed or upset, there are many things you can do to reduce or cure your pain. Physical therapy is the base of these treatments, and it can help you prevent other back problems in the future.

Putting ACT into ACTion

Pain can take up a lot of space in your brain. Sometimes, you might even feel like the struggle to avoid pain takes over your life. If so, acceptance and commitment (ACT) might be a good approach for you. With ACT, you can learn to accept that you have pain, but that you don’t have to put your life on pause to manage it.

Here’s an ACT exercise that can help you observe your pain without letting it take over. Close your eyes and take a deep breath. Notice any physical sensations. You might notice pain or tightness, the fabric of your clothing on your skin, or maybe even a feeling of calm. Next, notice what you hear around you. Finally, notice your thoughts without judging them. You are not defined by your body, what you hear, or what you think. You can simply observe each of these without letting them take over who you are.

When you accept your pain and commit to your life, you can suffer a lot less. This approach isn’t magic; it doesn’t get rid of your pain, but it does help you avoid sadness or anger taking over your life. It’ll allow you to get back to things that make you happy, even when your muscles and joints aren’t 100% better.

Injury and Identity

How do you define yourself? Well, that’s a complex question. You might be defined by many things on paper: your name, your age, your job… but what matters most is how you see yourself, or your self-identity. Your self-identity is how you perceive your own traits and your place in the world.

It’s easy for sports or physical skills to become part of our self-identity. The better we become at a sport — such as lifting weights, CrossFit, running, football, or tennis — and the more we commit to it, the more likely we are to include it in our sense of self. Our physical skills can become a big part of how we see ourselves. As a result, getting injured can take a toll on our emotions, not just on our bodies. Anger, frustration, anxiety, and depression are common reactions. We begin to question who we are if we can’t lift weights, run, or play tennis. We might ask, “Where do I fit in now?”

No one wants to think about getting injured. That said, it is likely that we will have an injury at some point. It’s a good idea to think in advance about the emotions that might come with injury. Here are a few things you can do to prepare yourself:

  1. Find interests and social connections outside of sports. This might take some thought if you devote a lot of time to training. What pros do you see in making time for new interests now, before an injury forces you to do so?
  2. Think about other things you enjoy in life. You might not get the same boost from other things that you get at the finish line of a 10K run, but there are sure to be other things you enjoy. What else makes you feel fulfilled, proud, or content?
  3. See what you have to offer that isn’t linked to physical skills. How do you self-identify outside of your sport? How much more do you have to offer the world, beyond what you can do physically?