The phrase ‘musculoskeletal disorder’ may not ring a bell — but the feeling might. The term refers to any type of pain in the muscles or joints, from chronic pain to injuries to post-surgical pain. Many of us have suffered from a musculoskeletal (MSK) issue at some point in our lives. In fact, one in two Americans is struggling with an MSK condition right now. And it’s causing economic ripples, especially in the workplace.

MSK care is now the highest health cost for employers

All this pain is costing us, in more ways than one. With $190 billion dollars spent every year on musculoskeletal disorders alone, it comes as no surprise they were ranked as the top condition impacting healthcare costs by almost half the participants of the 2020 Large Employers' Health Care Strategy and Plan Design survey. MSKs were also among the top three cost-driving health conditions of 85% of the employers. The strain MSKs put on employers and employees is clear. But how exactly do they affect your organization’s health costs? And how can you manage these costs without jeopardizing quality of care? Let’s dive into these questions.

How does MSK care impact medical costs?

The economic burden of MSK results from two types of costs: direct medical costs and indirect costs. Direct medical costs, as the name suggests, are the costs of treatment, such as surgery, imaging, drugs, and therapy. Indirect costs, on the other hand, typically consist of lost wages, worker replacement, and reduced productivity. Some of these costs - such as the effects of ‘presenteeism’ - are difficult to quantify, but can have a real impact on your company’s performance.

It creates a costly, redundant cycle of surgery, imaging, and pain medication

People struggling with MSK go through a series of distressing events to manage their pain. They typically start off by visiting their primary care doctor, who then refers them to a specialist, and sometimes also prescribes pain-relief medication. The specialist often requires diagnostic imaging to assess the need for surgery. In the end, whether the person goes through surgery or not, physical therapy is frequently the last cumbersome and time-consuming step towards rehabilitation. Alas, their journey seldom ends here, and they find themselves starting it all over again. For example, 20% to 40% of back surgery patients report having the same or increased pain one to two years after their surgery. This phenomenon is so common it even has a name — Failed Back Surgery Syndrome. The sum total of this vicious cycle amounts to around $190 billion a year in MSK spend alone — and a major slice of this cost pie is on the employer’s plate.

It leads to lengthy sick and disability absences

Between bed days due to chronic pain or days away from work while recovering from surgery, musculoskeletal diseases lead to more lost workdays than any other condition. MSK accounts for more than 216 million missed workdays, more than four times as many as depression patients. They also report six times as many bed days as people with depression and circulatory conditions, totaling more than 752 million bed days due to back and joint pain. Add worker’s compensation into the mix, and you can see how these indirect costs can easily amount to millions.

It lowers workplace productivity and quality of life

While absenteeism is a clear consequence of workers’ health problems, workplace presenteeism can be just as insidious. Presenteeism is the act of showing up for work despite being ill — a behavior often seen in chronic MSK patients. Why they choose to do it is unique to each person, but common reasons include job insecurity, work culture, and job demands. This phenomenon is not only detrimental to the employee’s wellbeing but also costly to organizations. People are significantly less productive when unwell, and eventually, overall organizational productivity is impacted.

How can we tackle MSK spend?

The challenge in successfully tackling the rising costs of healthcare lies in finding the balance between curbing spend and improving people’s lives. In the past, this hasn’t been easy - and Benefits leaders have had to make tradeoffs. In an effort to find this balance, employers are implementing more virtual care solutions. SWORD Health is one such solution. SWORD is the first tech-enabled MSK care provider to pair licensed physical therapists with an easy-to-use digital therapist, helping people overcome chronic and post-surgical pain faster and more cost-effectively — and our results speak volumes.

We lower your direct medical costs

Our clinically-validated approach strikes at the root of MSK spend by stopping the costly, ineffective care loop people get into when trying to manage their pain. By giving people access to best practice care for MSK - exercise, education and coaching - we reduce their risk of multiple surgeries and opioid addiction. Our programs have been proven to reduce surgeries by up to 75% and opioid use by 33%.. And because they can perform their sessions from home, participants no longer have to take time off work, nor do they have to get reimbursed for travel expenses to physical therapy appointments.

We get people back to health faster and better

Because MSK issues lead to more lost workdays than any other condition, getting people back on their feet sooner can have a big impact on your business. SWORD Health’s programs are highly engaging, showing unprecedented adherence levels. Because they follow their session without fail, they actually recover faster and better.

We help chronic MSK patients outsmart their pain

By providing chronic MSK patients with the right tools to outsmart pain, our solution drastically reduces their pain levels in record time while teaching them how to overcome the pain-related fears that keep them from living their best lives and doing their best work.

A better way to overcome pain, for everyone

When your employees are free from pain, they’re happier, more productive, and contribute to a healthier work environment. Tackling the MSK problem in your workplace is less of a challenge with the right partner by your side. To learn more about how SWORD Health can help you reduce your MSK costs by 35% and improve your employees’ lives, contact us today.

After a 2018 that saw us going from hope to reality, we went through 2019 knowing this was the year for growth. From pushing our clinical validation forward to closing our series A investment round with prominent investors, this year has strengthened the groundwork for us to build the future of musculoskeletal care. And we harnessed every opportunity to deliver on our mission.

More power to the people

In 2019, we provided the best care to twice as many patients! This means more and more people were able to follow their physical therapy programs from the comfort of their homes, spending more than 580,000 minutes with our digital therapists while saving more than a million miles of travel back and forth from PT centers.

A proven, better approach to MSK care

This year, we continued researching to prove we can provide patients with more effective physical therapy programs without them leaving their houses, facing traffic, and fitting appointments into their busy schedules. Two new studies showed our Digital Therapist can achieve better functional outcomes than conventional face-to-face physical therapy, not only short-term but also in the long run. And more people have started to notice how much of a fantastic alternative this is.

Clinical validation at the core, always

Clinical validation is the hallmark of what we do. In the words of our CEO, Virgílio Bento, “it is the touchstone for every development we bring into our Digital Therapist.” Appointing a Clinical Advisory Board was, therefore, the next step towards that end. This group of specialists, whose expertise ranges from orthopedics to cognitive psychology, is now assisting us in our long-term clinical strategy as well as supervising the clinical studies within the company.

New allies for our mission

We began the second quarter of the year closing our Series A funding round, where we raised $8M to fuel our efforts towards tackling musculoskeletal conditions, the number one driver of employers’ medical costs in the US. This round was led by Khosla Ventures, a prominent venture capital firm focused on breakthrough technologies that can solve big problems. We couldn’t have asked for a better ally.

A digital health company to watch

In 2019, we earned our place as one of the most promising digital health companies in the world. SWORD Health won the Employer Wellness & Prevention category at the UCSF Digital Health Awards, being recognized as the best digital health solution aimed at employers. Along with this award, we were also ranked as one of the world’s 150 most promising digital health companies at the CB Insights “Future of Health” conference; featured in Wired’s 2019 list of the Hottest 100 Startups in Europe; and given an honorable mention in Fast Company’s World Changing Ideas 2019.

A stellar team in the making

Only by having the most brilliant people working together can we achieve what we set our minds to — finding a smarter way to treat MSK. And we’ve been committed to finding the best. This year, we went further and hired not just great talent, but also the people who will help us scale and nurture this talent into the most stellar team in the digital health space.

2020: what’s next?

Next year, we’ll keep the momentum going. We’ll reach more people and change their lives for the better. We’ll continue our research and add new features to improve our Digital Therapist. We’ll strive to make musculoskeletal care even more engaging, effective, and accessible. These are more than promises. They are commitments. Here’s to a pain-free 2020!

When we feel supported, we can focus on what matters. This is why employee benefits are so important to keep your team motivated and engaged. And a well-rounded benefits package should anticipate something your workforce will eventually need: musculoskeletal care.

MSKs, the #1 driver of employers’ healthcare costs in the US

In the latest Large Employers’ Health Care Strategy and Plan Design Survey, Musculoskeletal conditions (MSKs) came in at the top spot — above cancer, diabetes, and cardiovascular conditions — when participants were asked about specific disease classes driving up their healthcare costs. MSKs include low back, neck and shoulder pain, and hip and knee disorders. Within the working population, MSKs are responsible for 34% of all lost workdays. Plus, an employee with a musculoskeletal condition costs 2.3x more than a healthy employee. In addition to this financial impact, MSKs take a personal toll on affected workers, from not being able to work to facing the risk of opioid abuse and surgery.

How SWORD Health elevates employee benefits

Along with the need to tackle musculoskeletal conditions in the workplace, 38% of large employers are considering the implementation of virtual solutions for MSK care over the next years. SWORD Health meets both the need and the want, providing the first and only clinically proven digital physical therapy solution that outperforms human therapists, lowers healthcare costs, and keeps patients highly engaged.

We take MSK care to a whole new level

SWORD Health developed the first digital MSK care solution that allows participants to independently perform their sessions at home while being remotely monitored by a clinical team. At the same time, we foster continuous education and behavioral coaching, so participants not only get better but stay better. We ensure they learn more about their condition, feel confident about their program, and change habits and behaviors to prevent or decrease the risk of further MSK problems. Our approach has shown to be faster and overall more effective than conventional physical therapy, and a reliable long-term solution.

We lower medical spend with MSK by at least 35%

SWORD Health’s digital solution cuts direct and indirect costs in musculoskeletal care by at least 35% — without ever compromising quality. We tackle the most frequent MSKs, including chronic pain, post-surgery, and injury care. With us, employers only need one solution to cover the MSK problem in their workforce. Our programs to manage back and joint pain have shown to dramatically reduce pain, opioid consumption, and surgeries, saving thousands of dollars in unnecessary drugs and procedures. When it comes to rehabilitation, our digital approach saves up to 55% of costs by reducing overall physical therapy spend, cutting out transportation costs, and getting employees back to work sooner than with conventional care.

We provide a highly engaging solution

With conventional physical therapy, almost 50% of patients quit their treatment after only four sessions. From transportation and scheduling constraints to not being confident about their own treatment, there are many barriers to adherence. Because we allow participants to perform their sessions at home, we’ve made musculoskeletal care more accessible and convenient to everyone, from people in remote areas to the ones juggling hectic schedules. And since we assign a licensed physical therapist to each participant, support and encouragement along the way are guaranteed. Our participants’ feedback speaks volumes about our approach, showing that SWORD Health programs are highly engaging and can keep people motivated through the end.

We enable a seamless implementation

Healthcare is complex and employee benefits must not add to that complexity but make it simpler. We do it by integrating seamlessly into care navigation platforms and enabling a frictionless deployment of our innovative therapy solution. We also tailor our programs to each person’s individual MSK journey and promote the use of second medical opinion services as well as cross-referencing to other solutions as needed.

Low back pain (LBP) is no stranger to most of us. Given its 57-84% lifetime prevalence, most people will be affected by LBP at some moment in life. In the US alone, about 66 million adults suffer from low back pain; in the working population, about 26% have reported low back pain in the previous 3 weeks.

Risk factors for low back pain at work

Low back pain is a symptom that can result from different abnormalities and diseases. Most cases of LBP, however, are classified as non-specific, which means no specific cause can be defined as a source of pain. Non-specific low back pain is usually attributed to muscle sprains or strains and bad postural habits, which can be associated with work-related activities:

• heavy lifting, pushing or pulling, so often required in more physical jobs, can lead to injury and, consequently, to back pain;
• poor sitting posture and inactivity, common traits of desk jobs, can make way for low back pain to settle.

Other work-related risk factors are:

• repetitive tasks, such as manual packing of goods;
• maintained positions, which often happens while working with computers or driving long distances;
• and vibration, from operating with tools.

The impact of low back pain on the American workforce

Low back pain is the leading cause of disability in working-age groups. Medical spend per adult with spinal problems is estimated at $6,000, with a total estimated amount of up to $102 billion per year. A recent study found that, although only 1.2% of US adults with newly diagnosed LBP and lower extremity had surgery, they still accounted for almost 30% of total 12-month health costs — $784 million. On the other hand, the total spending on healthcare for the other 98.8% who did not receive surgery was $1.8 billion. Interestingly, one-third of these patients received care that was inconsistent with clinical guidelines, which included expensive but dispensable imaging, and opioids. On top of this, guidelines also discourage the use of opioids, but one study showed they were prescribed for about 60% of ER visits for low back pain in the US. Also, prescription medication abuse is common in patients taking opioids for back pain, with up to 24% of cases showing aberrant medication-taking behavior. Surgery and opioid consumption are not only costly for employers, but also burdensome for employees. Surgery recovery typically takes long — around 12 weeks, and opioids are known to foster addiction. Therefore, it is easy to understand why low back pain is also associated with indirect costs related to work absenteeism and productivity loss. All things considered, there’s a need for new and effective alternatives to surgery and prescription drugs when managing low back pain.

How SWORD Health helps manage low back pain

SWORD Health has come up with a solution that provides positive outcomes while reducing health spending. In short, it brings advantages to both employees and employers.

We deliver better results

Current clinical guidelines recommend the promotion of exercise therapy and positive health as the first-line treatment for non-specific low back pain. Positive health entails person-centered care that promotes the concept of living well despite the pain by focusing on self-management and education as a means to avoid bed rest and continue with usual activities — including work. The SWORD Health LBP Program is an evidence-based 12-week program to tackle low back pain. Following the most up-to-date guidelines, this program is based on the three pillars of musculoskeletal care: exercise therapy, continuous education, and behavioral coaching, all delivered through our unique Digital Therapist and continuously supervised by our clinical team. Our approach allows participants to perform their program from the comfort of their homes, which not only is feasible and safe, it’s actually better. Some of the factors that explain this positive outcome are the participants’ higher engagement and adherence to a home-based program with real-time feedback on performance; the data-driven decisions the system allows our physical therapists to make; and the access to a behavioral training program.

We provide the best care while cutting medical costs

Because patients overcome their pain faster and better, they are able to return to work and their daily activities sooner than what was previously expected. And what’s more, because we educate them with strategies and new behaviors to conquer pain, their use of opioids dramatically decreases. Our approach translates into an up to 75% reduction in surgeries, a 33% reduction in opioid use, and an overall reduction of at least 35% in medical costs. If you would like to set up a benefits plan that helps you reduce your workforce’s burden with low back pain, reach out to our Strategic Business Development team.

From the very beginning, SWORD Health has followed two unwavering principles: we would never compromise our technological quality and we would never jeopardize our clinical validation. We chose these premises because we knew this was the only way to give patients the best possible musculoskeletal care. And we delivered. Our efforts have been recognized a number of times this year. SWORD was ranked as one of the world’s 150 most promising digital health companies at the CBInsights ‘Future of Health’ conference in New York. We were also featured on Wired’s 2019 list of the Hottest 100 Startups in Europe and won honorable mention in Fast Company’s World Changing Ideas 2019.

The best Employer Wellness & Prevention solution

Last week, we achieved a new milestone: SWORD won the Employer Wellness & Prevention category at the UCSF Digital Health Awards 2019. SWORD was recognized as the “best wellness or prevention digital health product or solution aimed at employers.” [caption id="attachment_892" align="alignnone" width="650"] Our Founder and VP of Strategic Business Development receiving the award on behalf of SWORD Health[/caption] We were picked among more than 500 global entries in the competition by a distinguished panel of judges from the technology sector, healthcare companies, medical professionals, and investors. After a couple of rounds, we were awarded the “best wellness or prevention digital health product or solution aimed at employers.” “This award validates SWORD as the company that is leading innovation in the musculoskeletal space,” said our CEO and founder Virgilio Bento. “To have a jury composed of the most brilliant people working in both technology and health acknowledge our excellence is especially satisfying.”

About SWORD Health

SWORD has developed a ground-breaking Digital Therapist, which has been proven to work more effectively than conventional physical therapy while bringing treatment to patients’ homes. The technology is set to make treatment of Musculoskeletal Disorders (MSD), which affects more than half of all Americans every year, affordable to millions of people. SWORD works with some of the biggest self-insured employers and health plans in the world to treat and prevent MSD. SWORD’s ultimate goal is to cut the costs of treating MSD by half. More than 50 percent of Americans struggle with MSD, requiring a yearly expenditure of $190 billion, making it the second-largest contributor to healthcare spending.

Pain is an evergreen topic when talking about musculoskeletal conditions. Although every person sees and feels pain differently, it plays the main character in their daily life. But pain can be demoted to a lesser, supporting role. How? By understanding pain, what it entails, and how we should behave towards it. Then, recovery won’t seem as difficult and unattainable as before.

Pain is not just pain

Pain is the way our body responds to a threat by prompting protective behaviors, which includes focusing attention on pain sources and avoidance. However, these protective behaviors may persist beyond the healing time, and this is when pain turns chronic, leading to pain-related disability. So, pain is more than just pain. It's the fear of pain and movement, the loss of function, and the inability to do the things we used to do out of the fear of them being harmful — even though most times they are not. However, feeling pain does not mean we have serious damage, nor it means we are doing further damage. The same applies to exercise therapy.

Exercise-induced pain is common and to be expected

When people struggling with a musculoskeletal condition are about to start their treatment, they often fear that physical therapy is painful. The answer is quite straightforward: yes, it is painful – at first. But this pain is normal, bearable, and nothing to be worried about. As the body gets used to the therapeutic exercises, the higher loads patients can tolerate, and the less and less pain they feel. In other words, there's a dose-response to exercise for musculoskeletal pain. Over time, people learn to expect increasingly challenging exercises while knowing they can tolerate them.

Moderately painful exercises are actually beneficial

Research has shown that doing moderately painful exercises offers better outcomes than doing exercises with no pain at all. It has also proved that exercising into pain has no apparent adverse effect when the aim is to manage chronic musculoskeletal pain. One of the discussed reasons for this response to exercise into pain was the positive impact on central pain processes, the immune system, and affective aspects of pain. In short, moderately painful exercises challenge the body’s threat response to pain, helping “reconceptualize” pain as safe and non-threatening. Consequently, people no longer perceive pain as equal to harm, being then able to reintroduce the same movements they were avoiding before. They learn how to cope with pain — and conquer it.

Being a coper, not an avoider, is the best way to conquer pain

During a painful event, it’s better to cope with pain and not give in to paralyzing pain-related fear. Changing the perception about pain is a tipping point between having a coping over an avoidance behavior. It includes challenging the attention bias, which happens when we focus our attention on how painful a particular movement is and end up feeling it more strongly. In other words, we end up catastrophizing pain. Exercising, as mentioned before, is a way of challenging this bias and reframing pain as not harmful. Another one is making a valued life goal a priority over pain. Focusing our attention on what really matters to us outweighs our pain-related fear. When we set goals and are optimistic about them, it becomes easier to hold back our fear-related protective behaviors.

After the pain, the recovery

SWORD Health team took all critical aspects of pain management into account when developing our solution for musculoskeletal care.

• We promote exercise as the first-line approach to MSK management;
• We make goal-setting a priority, enabling participants to divert their attention from pain to their more objective, valued goals;
• We foster continuous education as a way of empowering people to put pain into perspective and go through with the program despite it.

At the end of the day, our Digital Therapist yields undisputed results, with a reported 74% decrease in pain after only eight weeks — all while helping people stay away from opioids and surgeries, too. After we overcome the pain obstacle, the path to recovery becomes clearer. Pain is no longer a barrier to treatment, so people can set their minds into a more relevant thing: getting better, faster.

Falls are responsible for up to 30% of both fatal and non-fatal injuries, as well as for 10 to 15% of all emergency department episodes in older adults. Falls represent major expenditures in healthcare, with yearly medical costs estimated at $50 billion in the USA alone. Clinical evidence favors well-designed exercise programs in the prevention of falls. Most of these programs are costly and heavily dependent on specialized human resources: the therapists. Currently, there are no satisfactory solutions: those that exist are either expensive and complex or lacking enough clinical validation. SWORD decided to address this problem and test whether the Digital Therapist was a fitting solution for it. Through the SWORD Care project, we developed high-quality exercise programs specifically designed for fall prevention.

What exactly is SWORD Care?

SWORD Care is an integrated, engaging, efficient, and cost-effective approach to fall prevention, including both diagnostic and therapeutic tools. It includes automated assessment tools, thus overcoming the dependence on subjective and time-consuming scales. SWORD Care was developed in a two-year period, under a project co-financed by the Programa Operacional Norte 2020 through the European Regional Development Fund (ERDF). It was tested in a Porto-based facility with patients typically in the fall risk group. There was a total of 1130 sessions performed, adding up to more than 10h30 of treatment per patient during the 6-month testing period.

What results did SWORD Care get?

We used several different tools and scales to measure SWORD Care’s results: • Timed Up and Go Test (TUG): 32% improvement • Five Times Sit to Stand Test (5xSST): 25% improvement • Berg’s Balance Scale (BBS): 56% improvement • Short Falls Efficacy Scale - International (FES-I): 34% improvement The results show that participants improved their overall balance by over 55%, while also reporting that their fear of falling decreased by more than a third. The advantages of the program are perfectly showcased by this 79-year old participant, Mrs. Veríssimo: "There are things I do here I would never have done in my life! It helps me throughout my day, my joints feel less rusty, I can move a lot better. The pain is gone and so is my instability.” Participants were asked to rate the program and they gave it a perfect ten. Their feedback truly shows their satisfaction, as you can tell by Mr. Godinho, 81, who says "I can move my arms and legs better and do chores that used to bother me. (…) I'm perfectly capable of performing the sessions on my own. I'm very satisfied, I really like this."

If you’ve ever had the feeling you’re always on the road, you’re not alone. The latest numbers report Americans took 2.3 billion trips in a year, spending a considerable amount of time away from home — and their daily routines. In fact, traveling might seem like a perfectly good excuse for skipping a few sessions when you are following an MSK program. But if you want to get better fast, complying with the program and staying physically active are critical, so missing your sessions due to travel can hold you back. So how can you keep up with your sessions on the move? The solution is simple: by packing SWORD’s Digital Therapist in your carry-on.

SWORD’s Digital Therapist: your trusty travel companion

Our AI-powered digital therapist has been shown to help people complete their programs successfully from the comfort of their homes. But it’s just as useful while you’re away from home — here’s why.

It’s light and easy to carry

The Digital Therapist is small and lightweight enough to move around with ease. The tablet and motion sensors come in a practical case that fits any carry-on bag and is safe for air travel.

Setup is simple and fast

All it takes to get the Digital Therapist up and running is a WiFi connection and a stable surface for performing the exercises. Monica, one of our participants, took the Digital Therapist on vacation with her, doing her exercises by the pool with a bottle of wine as a weight. They do say necessity is the mother of invention!

You can do your sessions whenever you want

Whether you’re traveling for work or for play, you’re bound to get caught up between meetings, tours, and other events that fill up your days. With the Digital Therapist, you can easily fit sessions in whenever you find a break in your schedule.

Always on your side, anywhere you go

With its groundbreaking motion tracking technology and easy-to-carry system, you have enough reasons to add the Digital Therapist to your packing list. But the one detail that makes all the difference in the care you’re given is knowing you’ll get round-the-clock support wherever you are. Your therapist is available for live chat in your local timezone, and when you’re traveling somewhere far-flung, our on-call clinical team is there to support you. And because having someone watching over us boosts confidence and commitment, you’ll feel encouraged to continue your program — even while you’re away. To learn more about how SWORD can help you overcome pain wherever you are, contact us today.

Clinical validation has always been at the core of our company. SWORD’s Digital Therapist has already shown to recover patients faster and better than traditional physical therapy. However, there is more to be done, tested, and proven. Therefore, we are proud to announce the appointment of our company’s new Clinical Advisory Board (CAB). The group of specialists, whose expertise ranges from orthopedics to cognitive psychology, will help SWORD devise a long-term clinical strategy and supervise the clinical studies within the company. “SWORD Health knows clinical validation plays a crucial role in our company’s differentiation,” says SWORD’s CEO, Virgílio Bento. “It is the touchstone for every development we bring into our Digital Therapist. The addition of this knowledgeable group of clinical experts is not only welcome but also the extension of our understanding that science has to lie at the very core of everything we do at SWORD.” Members of SWORD Health’s Clinical Advisory Board include: Jose Rodriguez, MD (Chairman of the Board): Orthopaedic Surgeon, Hospital for Special Surgery; Editorial Board of Journal of Arthroplasty, Bone and Joint Journal, Clinical Orthopaedics and Related Research; Jorge Lains, MD: Physical and Rehabilitation Medicine (PRM) Specialist; President of the International Society of Physical & Rehabilitation Medicine (2016-2018); Gerard Francisco, MD, PhD: PRM Specialist; Board of Directors of the American Board of Physical Rehabilitation and Medicine; Chairman and Professor, McGovern Medical School, PRM Department; Chris Furmanski, PhD: PhD in Cognitive Psychology; Director of Innovation, Stanford Health Care (2013-2016)

Further evidence ratifies SWORD Health’s Digital Therapy

The newly appointed Clinical Advisory Board joins the team at a particularly fitting time, since SWORD also reported the outcomes of its most recent study, the first proving a digital solution (SWORD Digital Therapist) can achieve better outcomes than conventional face-to-face rehabilitation (35% better functional outcomes), requiring 80% less time from the physical therapist. The clinical validity of the digital program, that has once again shown very high patient satisfaction (91% rated their satisfaction with 10/10) and engagement (83% of patients performing five or more sessions/week), makes SWORD Digital Therapist an evermore interesting solution for both post-operatory and chronic scenarios. “On one hand, SWORD directly addresses the increasing rehabilitation needs we see every day in every health system,” says Jorge Lains, member of the CAB and President of the International Society of Physical and Rehabilitation Medicine. “On the other hand, this a solution that obeys all the golden rules of physical therapy: it’s intense, it’s repetitive, it’s task-specific. SWORD upholds not only the highest physical therapy standards but also the scientific and psychosocial ones.” José Rodriguez, who is also joining the CAB, says that “SWORD Health is leading an effort to engage patients more directly in understanding their role in their rehabilitation, and in this way inspire them towards improved functional outcomes.” The prominent surgeon from the Hospital of Special Surgery also states that “Being part of this effort is both fun and exciting. Helping people get even better is why we are here.”

Following surgery, the body undergoes a period of healing. Postoperative physical therapy is the first-choice strategy for faster and better recovery, helping the patient return to work and perform everyday activities as they would before the surgery. The rehabilitation process usually entails an intensive exercise program that extends for weeks and can include both in-clinic and at-home sessions. Committing to the process and maintaining adherence are the most fundamental aspects of physical therapy — and the hardest to accomplish, too.

The many barriers to rehabilitation adherence

Non-adherence to physical therapy programs is the result of the many obstacles that patients encounter or perceive along the way. Barriers such as transportation problems — especially in those cases where patients can’t drive, thus becoming a “burden” for family or friends —, childcare needs, work schedules, and financial constraints are common reasons to fail appointments. Other barriers, however, could be as limiting, especially when talking about at-home physical therapy sessions. Poor self-efficacy, that is, when the patient lacks confidence in their ability to perform a given task, can determine whether the treatment is effective or not. Left on their own, without qualified supervision or feedback, they no longer feel confident they are on the right path.

How SWORD’s Digital Therapist brings barriers down

To tackle this problem, different strategies and approaches have been proposed, and our Digital Therapist brings some into play:

Freeing patients from appointment scheduling

Perhaps the first advantage that comes to mind when talking digital is convenience. Because the Digital Therapist supervises the therapy session from the comfort of the patient's home, barriers such as fitting an appointment into their busy days or lacking transportation to a clinic are no longer an issue.

Giving structure to at-home rehabilitation

Improving self-efficacy is a top priority when it comes to increasing rehabilitation adherence. By giving patients access to demo videos on how to perform each exercise along with real-time feedback on their performance, they become more confident in their ability to go through with the prescribed program. That’s exactly what the Digital Therapist gives them: structure, supervision, and positive reinforcement.

Allowing patients to track their progress

Another way to improve confidence and self-efficacy is to increase patient empowerment by giving them a sense of control over their own rehabilitation process. With the Digital Therapist, patients have access to a summary of their performance in each session. Alongside the guidance from their human physical therapist, this allows patients to track their progress and understand not only what they still have to improve but also how far they have come.

Improving patient engagement through gamification strategies

By turning the physical therapy program into a game — with specific goals to achieve and rewards to earn — the Digital Therapist gives patients a sense of purpose and accomplishment during the rehabilitation process. This gamified therapy taps into the innate human needs for achievement and reward, compelling patients to improve their performance and attain more powerful results. More motivation to improve means higher patient engagement and, consequently increased compliance. And that is an important step forward to success.

The Digital Therapist’s most powerful asset: the human touch

SWORD’s rehabilitation programs go beyond the digital approach. We believe in human+machine collaboration. Every patient is assigned a Physical Therapist, who is always available to provide support and encouragement when needed. Knowing that their Physical Therapist is there to help them throughout the rehabilitation process can make a difference in the patient’s progress. In fact, they are most likely to adhere to the prescribed program if they perceive a positive relationship with their therapist. This positive relationship also fosters open and transparent communication, which is important to address patients' fears and anxieties about pain and self-efficacy, building up their trust in the process. And to make sure patients not only get better but stay better, communication is focused on continuous patient education and behavioral change, so they can achieve long-standing results, not just temporary.