Virtual physical therapy provider OneStep using smartphones to determine upper-extremity range of motion

OneStep has expanded the capabilities of its technology, which transforms smartphones into clinical-grade motion analysis devices, to assess upper body motion.

By holding a OneStep-enabled smartphone and moving the arm in directed ways, physical therapists are able to assess range of motion to inform post-surgical recovery and treatment of functionality of joints. The platform allows patients to connect directly with physical therapists to develop care plans including OneStep’s library of over 700 video exercises.

OneStep’s patented technology has been used most notably to assess a user’s gait after just 30 seconds of walking. OneStep is also able to take data collected regarding gait and predict and alert providers to a patient that may be a fall risk. Just as with OneStep’s previous offerings, no additional wearables are needed to asses upper extremities.

“In addition to capturing gait data with a phone in a pocket, we're also able to have the patient grab the phone, put in their hand, lift their arm up overhead, and we are able to capture reliable range of motion measurements,” Patrick Tarnowski, OneStep’s chief commercial officer, told Fierce Healthcare. “What we're doing is giving our providers an even more enhanced 360-degree point of view of their patients so our technology is now applicable to all of their patients who present with some kind of an upper extremity problem.”

Traditional range of motion measurements, taken in a clinic with a goniometer, have a margin of error plus or minus five degrees, according to Tarnowski, who previously worked as a physical therapist.

He said OneStep’s upper extremity measurements currently have a high correlation to the gold standard of traditional range of motion measures.

"As the patient uses their hand to lift their arm up overhead, we are looking for range of motion, and that's important for the provider to be able to address function,” Tarnowski said. “We can then track progress over time, or lack of progress over time. We're fully able to make that type of assessment using the phone.”

In recent years, evidence has pointed toward the effectiveness of noninvasive treatments for musculoskeletal injuries and disorders. Overuse of opioids, surgery and imaging point to a pay-for-service model directing treatment without substantial long-term benefits to patients, according to OneStep executives.

Research regarding upper-extremity musculoskeletal disorders (UEDs) has been spotty with prevalence ranging from 1.6% to 53% of the population.

Across the research, UEDs are tied to occupation and work with the highest prevalence being in jobs with high-force, high-repetitive manual movements including grinders, butchers, grocery store workers and frozen food factory workers. Women are more likely than men to report UEDs.

Over 120 million Americans require physical therapy for at least three months every year, yet less than 10% (11.7 million) access a physical therapist, Tarnowski said.

OneStep’s platform functions as a library, a virtual point of care and a collecting space for a handful of metrics including range of motion tests, gait tests, patient-reported outcomes and any additional information a provider may need to develop a treatment plan.

“Our patients are able to provide direct feedback to our providers using the platform, so all of this information is served up to the providers in this dashboard,” Tarnowski said. “It helps them paint a picture virtually of their patients. Now we add into that valid range of motion measures for the upper extremity. On top of all of those services, our providers are able to use our synchronous and asynchronous and video messaging with our patients to help them receive care when and where and how best to achieve it.”

Virtual physical therapy has been expanding after initial innovation required to bring the innate physicality of the care to the virtual space. Digital physical therapy is an area ripe for investment. MSK funding grew sixfold between 2020 ($236 million) and 2021 ($1.4 billion), according to Rock Health's annual funding report.

Many companies require that patients use additional wearable devices to be able to assess exact movements, but recent offerings like RightMove Powered by HSS avoid the use of additional technology, which many worry can be a barrier to care.

The American Physical Therapy Association is a longtime advocate of virtual physical therapy provided by licensed physical therapists, citing lower numbers of licensed physical therapists in rural areas, and gaps in access to care as reasons to expand access to digital health care.

OneStep also states that a virtual space allows for increased visits and additional support to address chronic ailments.

Tarnowski sees that in the future OneStep can expand in new areas of MSK needs. Low back pain is on the near horizon for the health tech company.

“When we look at the prevalence of low back pain in our society, it's very high,” Tarnowski said. “Eighty percent of the population at some point in life experiences low back pain. To be able to help our providers with virtual tools that can look at spinal injuries is also very exciting.”

The Tel Aviv-based company was founded in 2018 and boasts a 75% 12-week retention rate for patients actively engaged in their at-home rehabilitation through the app, notably 40% higher than patients only using in-person physical therapy.

OneStep’s partners include physical therapy clinics throughout the U.S. such as Mount Sinai, University of Utah, AposHealth, Haifa University and smart surgery provider Kinomatic.