Rehabilitation and Private Pay Applications TRAZER Based Solutions

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1 TRAZER Based Solutions This overview provides the background to assist rehabilitation professionals in evaluating how TRAZER technology can be used to enhance patient care and expand their business opportunities. Alan W. Davis, M.D. Mark Schickendantz, M.D. Barry J. French, TRAZER Inventor Edward J. Ash, PT, ATC Movement defines functional capability from sports performance to the most basic requirements for independent living. Job or sports injuries, arthritis, obesity, heart disease, diabetes, stroke and other neurological disorders and diseases, and simple inactivity whether in children or seniors all affect movement. And in each case, movement is essential to the full restoration of health. Measurement and enhancement of movement form the core of virtually every rehabilitation or training program. TRAZER allows the clinician to view disability and capability as a continuum of the capacity for movement. TRAZER is equally applicable to a patient using braces or crutches, or to an elite athlete returning to play. TRAZER S PATENTED MEASUREMENT AND CONTROL OF MOVEMENT PERFORMANCE AND PHYSIOLOGICAL RESPONSE ARE THE FOUNDATION OF TRAZER-BASED PROGRAMS. TRAZER s patented technology merges realtime, 3-dimensional tracking of body position with simulation technology to deliver gamelike, interactive protocols and games controlled by actual body movement. Progressive movement challenges designed to motivate and improve performance can be as gentle as raising a hand or as demanding as a series of reaction-timed vertical jumps. TRAZER allows unconstrained, free space movement that can be easily controlled within individual limitations even by telemetered heart rate. And every movement is precisely measured.

2 This combination of engaging visual motivation, real-time visual feedback, computer-controlled progression and precise measurement has proved uniquely effective for rehabilitation and training of functional strength and power; range of motion, balance, coordination, reaction time, movement speed and cardiopulmonary condition. TRAZER gives the clinician user-friendly tools to precisely control the direction, distance and rate the user travels in response to both unplanned and planned movement cues. TRAZER tracks in real time positional changes of the user s body core (the pelvic area) in response to interactive drills, protocols and games. Control of one s core is the one most important factor in determining skilled, purposeful movement. By measuring this single variable, a real measure of functional performance can be made - that of the user s ability to successfully negotiate his or her environment. Control of the pelvis during domain specific activities in the healthy user will be indicative of skilled movement - with smooth, bell-shaped acceleration curves and minimal variability. By contrast, injured and poorly trained individuals will exhibit inconsistent velocity profiles and high variability during movement. TRAZER also provides protocols for the user s upper limbs. TRAZER s planned and unplanned stimuli (cues) prompt from the user the desired response, while high-speed positional tracking enables real time quantification of such performance parameters as reaction time, velocity and moment-to-moment core (Center of Gravity) position, jump height, etc. TRAZER IS A TOOL TO BREAK DOWN COMPLEX HUMAN MOVEMENT INTO DIVISIBLE COMPONENTS. Beginning with simple, easily performed reactive movement tasks, TRAZER varies the intensity and complexity of the reactive movement activities. The user s compliance with the exercise prescription determines the rate at which he or she can be progressed. TRAZER protocols range as follows: Low Amplitude Protocols are characterized by low stress displacements of the subject s body core these activities do not require the subject to change his or her postural base of support. Emphasis is on balance activities and effective weight shifting. The goal of these protocols is to improve the subject s ability to maintain equilibrium and control of the center of gravity/mass (body core) within a given stance (feet fixed), and to improve fundamental postural control, with incorporation of cognitive demands with simple movement tasks. Intermediate Amplitude Protocols are provided for the goal of improving symmetry in basic movements, including linear, lateral and balance by minimizing variability in the movement rate, as well as neuromuscular enhancement (dynamic balance, agility, proprioception) and cardiovascular conditioning. High Amplitude Protocols develop movement skills and strategy. Emphasis is on training reaction and anticipation skills while enhancing the ability to confidently perform complex movements. This phase is characterized by

3 sports and activity specific drills designed to achieve maximal function. The movement skills used in this phase demand maximal accelerations and decelerations with smooth application of power. BY TRACKING AND CONTROLLING KEY PERFORMANCE AND PHYSIOLOGICAL PARAMETERS, TRAZER IMPROVES SAFETY AND PROVIDES THE FEEDBACK THAT WILL ENHANCE MOTIVATION AND COMPLIANCE. TRAZER s unique capability to monitor heart rate and measure and report caloric energy expenditure during free movement activities provides real-time exercise control and motivation. TRAZER can provide individualized motivational targets while automatically limiting the demands of each activity to match the current fitness level of any participant. By offering an exercise environment that is safer and more controlled than typical fitness programs, and by providing engaging, gamelike activities that automatically adapt to individual abilities and conditioning, TRAZER creates effective new programs for weight management, wellness, and functional training for demanding work environments and safe, enjoyable daily living. TRAZER applications include medically reimbursable services for Pediatrics, Orthopedics, Sports Medicine, Geriatrics, Neurology, and Cardiology while adding numerous private pay possibilities for extended rehabilitation, health enhancement and performance training programs. JOB INJURY, SPORTS INJURY AND GENERAL ORTHOPEDIC REHABILITATION. Whether recovering from a sports injury or some other musculoskeletal or neuromuscular disorder, TRAZER provides the specialized, age appropriate equipment and programming to truly engage and progress the patient in the rehab process. With TRAZER, functional performance and progress are objectively measured. Every weight-bearing challenge is automatically matched to each individual s current capabilities. TRAZER maximizes the patient s functional recovery and return to independence with greater safety and selfconfidence, and a reduced chance of reinjury. Combining exercise with virtual reality has the advantage of increasing stimulation interaction and, since it makes the exercise session more engaging, it provides a useful tool to integrate cognitive and physical tasks the opportunities it (virtual reality) affords for both re-learning and assessment are immense. Greatly, Improving Cognitive Function After Brain Injury: The Use of Exercise and Virtual Reality ENHANCE COMPETITIVENESS, EXPAND REFERRAL BASE, AND INCREASE PROFITABILITY. Clinicians can enhance their competitiveness and increase profitability by adding new services that are valuable for existing caseloads, but that will also increase the referral base among other medical providers. Some or all of the following should be applicable to a clinical practice. Senior health & fall prevention program Pediatric obesity program Cardiac rehabilitation Stroke rehabilitation Sports injury and orthopedic rehabilitation Weight & chronic disease management

4 SO MUCH MORE THAN JUST A MEDICAL REHABILITATION TOOL. Our customers have used TRAZER to enhance their rehab programs, screen local sports teams, expand their referral bases, and turn patients into paying clients who come back even after their insurance coverage runs out. ADD PRIVATE-PAY, CASH-BASED PROGRAMS AND ACTIVITIES. Clinicians can expand their business to include private-pay services and programs that will actually leverage their existing base of patients, their families and friends, referring professionals and the rest of the community network that a clinician works so hard to build. Using the same technology that will differentiate an existing medical practice, and increase its competitiveness and profitability, clinicians can offer exciting new cash-based activities that will allow them to reach deeper into their community. All are tightly focused on health, fitness and injury prevention. Kids sports fitness Back-to-sports for seniors Sports performance enhancement and injury prevention for the weekend athlete Weight management Extended rehab programs (Why lose patients to personal trainers and fitness clubs?) TRAZER in a facility s service area should be a powerful marketing tool. Documentation of improved outcomes should increase professional referrals, and exciting and engaging treatment protocols will generate word-of-mouth recommendations and improve compliance. Senior Health & Fall Prevention Exercise that includes movement retraining, environmental awareness, postural control, low level cardiovascular and muscular strengthening, and visual/cognitive processing may be the best fall prevention. The Cleveland Clinic study titled, Response time is more important than walking speed for the ability of older adults to avoid a fall after a trip, demonstrated that older adults who are at risk for falling can achieve a dramatic increase in safe walking velocity by improving their response time. The measurement of reaction time in a simulation, whether the patient is responding to planned or spontaneous movement stimuli, is one of TRAZER s patented constructs. While I initially thought TRAZER would work best (or only) with a younger patient, this does not appear to be the case. It works equally well across the lifespan. I have not found an age population that TRAZER does not work with.the TRAZER system has brought a lot of excitement to the clinic. Most importantly, it makes the rehabilitative process fun ultimately increasing compliance which is critical for success. Dr. Michael L. Voight, DPT, OCS, SCS, ATC, Prof. Belmont University Cardiac Rehabilitation TRAZER cardiovascular/aerobic training protocols create a truly effective methodology to return the heart patient to successful and enjoyable leisure sports participation with functional, weight bearing, computer controlled rehabilitation activities. These activities feature a low perceived exertion rate, and continuous, real-time telemetric monitoring of heart rate, and the ability to set minimum and maximum heart-rate controls. With TRAZER, a greater number of cardiac patients can achieve or return to an active lifestyle.

5 The Authors: Alan Davis, MD, is a Cleveland Clinic orthopaedic surgeon, and the team Physician for the Cleveland Barons American Hockey League (AHL) team. He was an academic All- American at Michigan State, and has served as Traq Ltd s medical director since Mark Schickendantz, MD is an orthopaedic surgeon, director of the Cleveland Clinic Center for Sports Health and head team physician for both the Cleveland Indians and the Cleveland Browns. Barry J. French, the inventor of TRAZER, pioneered the application of simulation for the enhancement of health/fitness, physical performance and kinesthetic learning. He has been awarded more than a dozen U.S. patents. The technologies claimed by these patents are currently being used by the vast majority of mainstream video game makers. He has demonstrated TRAZER on Oprah for the Surgeon General, and has appeared on numerous other national TV shows. Edward J. Ash, PT, ATC is the owner of ACTIV PT, a private practice in Richfield, OH. He developed the TRAZER Rehabilitation Protocols for Knee, Ankle, Hip, Balance, Vestibular, and Knee Prevention.