How much would you pay for an SCI bootcamp?

[mk99]

How much would you pay to work out at a centre that has the following:

Lokomat 1 hour a day (ie: the best suspended treadmill trainig)
FES bike 1 hour a day
Agressive PT 1 hour a day
Full use of all other equipment all day long

How much per month? And how would this compare to Project Walk? As I understand Project Walk relies more on PT whereas this centre relies more on treadmill training, FES & other advanced equipment.

How much per month would this be worth to you?

[Max]

I would like to perefraze you:-How much I can afford paying per month?

Probably 1500-2000 Can per month for 2 years...

After I would be out of my resourses http://sci.rutgers.edu/forum/images/smilies/wink.gif

==============================
"Those who seek to predict the future... might first look to the past. The past is a mirror -- and those who ignore its sometimes dark reflection, are doomed to repeat it... Will it be those seeking redemption who shall decide the future... or will those driven only by greed and envy shape our destiny? Even a hundred years later, the outcome is still very much in doubt. .." Outer Limits(Heart's Desire)

[Jeff]

themselves and their families while earning no money......and spending plenty.

There will always be a market for this service because so many SCI receive settlements and can afford it. I think a device for the home that can be purchased and used a couple hours per day will be more popular.

I'm also considering living in a very low cost-of-living country for a year after I get a cure therapy. I'd like to band together with a few other SCI, buy the equipment, pay a small amount to live each month, and work my ass off at recovering. Living large on $300/mo vs. scraping by on $3000/mo is actually rather appealling to me. Having experienced it first-hand. It's the only possible way I can possibly imagine taking a year off to focus on my recovery. I will also certainly wait until I have an OEG transplant. After 22.5 years of paralysis I'm going to be patient and marshall every force and circumstance in my favor. For a tremendous push. I plan to do this in my early forties. I was injured at sixteen. Pretty frigged up to spend that much time in a wheelchair. But I've done the best I could.

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[T-Bone]

I think there should be at least one high quality SCI rehab facility per state. We now have one for the entire United States (Project Walk). This is straight up common sense. If you have something working below the injury and you only need 10% of your spinal cord to live a normal life then intense automated therapy will train the nerves that do work to do things that they never have done before. This is why the auto ambulator will be an important piece of equipment towards this. The only thing is that it costs $100,000. It's a great piece of equipment, but there has to be a cheaper way to engineer it.

[Jeremy]

Hi Mike I don't know if your interested but Chedoke-McMaster Hospital in Hamilton has a Locomat.

"I'm just a dreamer who dreams of better days"

[mk99]

thanks for the replies.

Jeremy, I plan on taking a small trip out there soon to check it out in action. As I understand there are only 4 Lokomats in North America right now and, as Project Walk clearly shows, there is demand for this kind of intense & agressive PT. All 4 are in University Research type centres and IF they accept you I think you get the boot after 3 months. In my opinion there is a market for commercial availability of such technology for more people.

I am looking at doing something similar as Project Walk but focusing more on cutting edge equipment and am now trying to get a feel for # of people out there who would be willing & able to committ to at least 1 month of this kind of therapy.

Jeff, I suspect there are many people out there who have some kind of settlement and could afford to spend maybe $10,000 for 3 months of this kid of treatment. (plus rent & food). Yes most of these people have settlements but I also look at it this way:

most people won't think twice about spending $20-$30,000 on a car every few years. What's $10,000 for 3 months on cutting edge equipment and intense 1:1 physio in order to have a CHANCE to get out of their wheelchair. Since a lot of SCIs don't work, they can more easily afford (time wise) a 3 month committment to a program like this. Many families would be willing & able to cough up some kind of $ for this type of therapy. Obviously, incomplete injuries stand to benefit a lot more than completes.

The project I had in mind is not designed to make an obscene profit. I want to cover my costs (Lokomat alone is around $200K), be compensated for my time and price things in a way that as many people as possible benefit. I think it can be done.

[SCI PILOT]

Mike

We looked at setting up something similar in Calgary, we had raised $ 250K of venture capital and we're going to partner with an existing physio loction as to try and keep the initial overhead and capital down. This way we could use the money to buy equipment.

We then had my accountants run a business plan on what each machine needed to generate for hours and of course revenue per hour.

We then contacted 3 insurance companies, AADL and WCB. The feedback from the potential payees was quite negative as there was no proven results that they could read.

At the end of the day we determined there is a need for the facility but there is no-one to pay for it.

I hope your model shows that it can be done. If your successful we would love to copy your plan out west.

Jim

[mk99]

Jim,

thanks for the info. It's a real balancing act. On one hand you can price things out of this stratosphere and the model works. But then you have maybe 2 people per month working out and the rest of the time the equipment just sits there. Clearly, that's not very good. On the other hand if you price low, you get overcrowding and lose money.

What kind of pricing model were you using? At this point I am leaning towards a mixture of: monthly flat fee users (people travelling from other areas of the country or the US) combined with locals who have a third party (ie: auto insurance) picking up $80-$100 per visit tab.

In Ontario many people already do long term physio/rehab at $80-$100 per visit. I do this myself 3-4 times per week. Some of these people would benefit more from my program than they are getting now and they are receptive to the idea.

could you email me and we can talk in more detail?

mkowalski99@hotmail.com

[chasb]

"(Lokomat alone is around $200K),". I think you could probably get a brand new one for 150k US.

[Chris Chappell]

Mike, I'm in the midst of pursuing a similar venture here.

Actually I'm confident I can obtain the facility, equipment, personnel etc. and the initial funding.

My biggest fear / challenge is finding people to commit. And with that commitment(sp) will those people be the right ones who can justify the results which will in turn convince the insurance companies to pony up?

We all know the theory. Proving if it works is another challenge. Frustrating.

To me the sci community is a fickle bunch. And trying to determine who wants it and is willing to work for it vs. those who talk a good game is a shot in the dark at best.

Good luck with your program.

Onward and Upward!

[Jeff]

That's the reason John McDonald is pursuinng a large trial of acctivity-based recovery. So that insurance will be convinced it's cost-effective. I hope they see the light.

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[jway2002]

Chris, Mike,
A buddy just opened a gym here and has offered a free lifetime membership
to my son. I don't think it would take much to get him to house the right equipment at little or no charge. Going to see what he says. Have talked to a few of the guys we met in rehab and they are all for this. I think Chris has the right idea with his plan on rehab. I wonder if Project Walk would franchise out their idea at little cost. What do you guys think?

[mk99]

I've had a bigger problem trying to find PTs who believe in something more than traditional "work with what you got, go home & learn to live in a wheelchair".

Where do you find PTs like they have at Project Walk?

[Chris Chappell]

Jway, great news from you. Keep it going. The franchise idea, one I've spoken to Ted (PW) about is probably a year or so off but definitely on the horizon. The PW people are awesome at what they do. Business is not what they do. Not to say they can't but its just not their thing. In the future, who knows? And I'll probably get flamed for this but I really don't think that making money is PW's goal. They want to prove a successful program. If and when the profits outweigh the expenses they should then be able to capitalize.

Mike, the beauty and big advantage, imo, PW has over newer programs like yours for instance is that they started with one client (Mike) and one trainer (Ted) in a garage. Then two clients, three etc. In fact Eric (Snowman) was the first hired trainer almost three years ago who worked virtually for free. Now there's about 16 trainers who never have worked traditional sci pt. Therefore they don't know any better. Ted, Tammy and Eric train them one by one on the PW system. This is why you may want to consider students of exercise phys., kinesiology(sp), pt, before they go into the hospital / traditional rehab facility. As I've stated many times, and having been introduced to the PW program, the difference (what you're paying for) is the non-traditional thinking and application.

Back to my original point. PW has an advantage in that they're three years ahead with a valuable, successful program built virtually from the ground up one client at a time. Trying to do it en-masse initially in my mind creates a different challenge / environment.

Jeff, you're right. In order to prove the effectiveness of a program like Dr. McDonald's or PW, etc. so that the insurance companies will pay there has to be a group of candidates measured pre, during, and post the exercise program. CR as one candidate is not going to justify it. But maybe the Wayne State Univ. study (100 candidates) at PW will?

Insurance companies rely on the doctors, the doctors rely on the data, and the data is only as good (accurate) when measured consistently over a large group.

PW has the large group and a quickly growing reputation (media for example) for success. People are flocking to them. People who want to and will be working their butts off. Another I recognized at PW is that if you weren't participating as hard as possible in your own recovery you're easily cast aside because there's someone right behind you ready to take your spot.

And because of this you will have a successful (WSU) trial which will result in more funding / insurance reimbursement.

Can other states copy this? Yes. Will it take some time? Yes.

Jeff, you eluded to this earlier and its a very important point. To me the real future (5yrs from now) is in the home based equipment / programs. A godsend to insurance companies in that the expense would be 1/8 a PW. What we need, and its slowly coming (lokomat, autoambulator, etc.) is the equipment to improve, the costs to come down and the application (across many maladies) to spread. But all of this is somewhat contingent on the success of Dr. McDonald, PW, etc. For if they are successful and the docs, rehab specialists, hospitals and ultimately the insurance companies buy in to the exercise induced recovery method and theory then we'll all have fes, a gaiting program, personal trainer either in our home or in a nearby facility. That would be awesome.

Sorry for the long post.

Onward and Upward!

[Mike C]

I thought Canada has social medicine, but I take it that doesn´t include long term PT. PT´s earn over 50k a year in the US, not sure how it is in Canada. That could be the reason why PW doesn´t employ Physical Therapists or Physical Therapist Assistants. Good luck finding qualilified PT´s in your area.

Where I´m at, the neurological patient has a 40min. to 1 hour time limit. Depending on the PT practice, an appointment time period runs at either 20min or 30min time intervals. Which time interval is chosen depends on how much money a practice wants to earn vs. work load. Either way, the payment received from the public health insurance companies is the same. Private companies pay more of course. Best bet for a neuro practice would be 1/2 hour Lokomat, and 1/2 hour Bobath or Vojta training. The patient would then work out on their own after the official appointment is over; using Uppertones, flywheels, free weights, Easyglides ect.

I don´t think opening a fitness studio for neurological patients here would fly unless it was located in a major city such as Frankfurt or Munich with a high population. The costs would be high, and few would be willing to pay for such services, especially when most of the neuro patients are older and get at least mediocre physical therapy close to free. Plus, German insurance companies would never pay for services not preformed under a medical umbrella.

Good luck with your concept, after all, every land thoughout the world needs to have advanced rehabilitation facilities, and each land has it´s own playing field and rules to navigate through.

[mk99]

Mike C,

each province in Canada is different. I live in Ontario and although yes we have social medicine (at least for now) it doesn't cover many things such as long term PT. If you have private insurance ontop of regular insurance they may have to pay for long term PT for the rest of your life.

PTs earn around $50K+ Canadian here (which would work out to about $35K US).

I have talked to PTs here who are open to the concept... the problem is that although they are experienced with SCI, many of them have the traditional mindset that is EXACTLY what I don't want. I think it was Chris who suggested hiring new PTs straight out of school. Then again, these people don't even know about catheters or bowel programs. I'll give this some more thought & do some more digging.

thanks for the input everyone. I hope something can really come out of this.

[foster]

you have to find pt that really believe that you can recover and not to live in a w/c. they have to be willing to work really hard and stay at it because somethings might take a couple of days or months. the people that are there working out will let you know who is good and bad. we are paying somebody to kick your a--.

[etexley]

I really feel that clinical therapy should be more geared towards getting people OUT of rehab and show them how they can do it at home in their homes. The sooner people get into the real world and back to their jobs, the sooner they can begin to really understand how to live their lives with their injury.

What is the correlation between inpatient rehabilitation time and quality of life? Rehab is far too expensive in the United States. For two hours a day (one hour of PT and one hour of OT) it's simply not worth $500.00 a day.

I would be quite happy to meet and work with acutely injured patients in my area. Id like to talk to them about my experiences and show them the things that I've learned to cope with my injury. The important thing is to show people that recovery is something they need to work for with everything they have.

[Chris Chappell]

bump for newer members

[Faye]

Is there a lokomat out there yet, at a place like PW? Anybody working on getting one yet?

[Chris Chappell]

bump.

[Melis]

In response to many people saying they want to find Physical therapists who do not go by the standard PT and send you on your way after insurance stops paying. I am in Massachusetts where I am involved in a new program, Northeast spinal Cord Initiative. I have five participants whom work with me and an army of volunteers. Headed by a nurse doing her doctorate in research, we put them through an exercise program. FES and functional activities, lifting, balance and stabilization, etc. How am I qualified, I am an athletic trainer. Traditionally in colleges, high school and professional sports, we treat actue and chronic injuries, rehabilitation to return to play is one of our specialities. It is this frame of mind, getting back to the game, that I focus my programs around, not traditional PT. My understanding is Project Walk is not staffed by Physical Therapists but rather Exercise physiologists and strength and conditioning specialist, CSCS certified. Something to look into as far as getting professional help with programs without the traditional PT mindset. This is not to say PT is not important and I support it very much so but as many of you know, PT is not funded long term and once goals are met, you are done.

Melissa Ryan

[etexley]

Unless I could keep up the regimen for a year or more, what would be the point?

I like working with a trainer. The trainer shows me things that I can do in the gym, on my own accord. In this way, I can adapt my own exercise routine.