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All right, welcome to the AdaptX podcast where we have conversations with individuals who

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are building accessible businesses, advocating for inclusion or excelling in adaptive sports.

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Our intention is never to speak on behalf of those with disabilities but provide a platform

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to amplify their voice and share their ideas to a more accessible world.

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Today we are joined by Hal Hargrave.

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Hal is the owner and founder of the Perfect Step and presently serves as a role of facilities

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manager and as a board member for the Perfect Step corporate team.

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Hal became a part of the team back in 2007 shortly after he sustained a spinal cord injury

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in an auto accident.

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Hal was approached by Mike Alpert and the Claremont Club in an effort to try and provide

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treatment to Hal and be a part of his ongoing therapy regiment and recovery.

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Hal thank you for joining me today.

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Well, I should be on.

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I'm looking forward to our conversations.

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So let's maybe introduce the listener to what the PerfectSTEP is.

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So just global vision of what the business provides as a service.

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Yeah, I think the global vision is this and I've been noted to say this recently, but

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our intention is to become the largest neurological recovery network in the chronic stage of recovery

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in the world.

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And we have that type of affluence and thought and idea out of the mere sake of wanting to

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provide affordable health care in every major region across the world to people who are

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living with debilitating needs.

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So the PerfectSTEP exists to intend to provide an inclusive program option for people that

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are living in the chronic stage of recovery with varying levels of neurological disorders

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resulting in paralysis.

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So we treat an array of different areas of treatment in terms of diagnosis or injuries,

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ranging from spinal cord injury, stroke, and traumatic brain injuries are our top three

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getters in terms of the individuals that we serve and those are all onset by injury.

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And some of the other diagnoses that we treat that have been diagnosed by way of disease

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or onset at time of birth would be things like cerebral palsy, multiple sclerosis, ALS

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or PLS, hereditary spastic paraplegia, ataxia, Parkinson's and more.

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And so we provide an inclusive program treatment option for those in the chronic stage who

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are seeking a high intensity approach towards recovery and care that is very reminiscent

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of that of a very holistic model and approach where we address the whole mind, body and

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soul and we provide disciplines here at our flagship location to that of our physical

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model of care, which our specialists are working one-on-one with our particular clientele.

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And we also have other holistic service options on site here in the form of chiropractic,

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acupuncture, massage therapy and mental health therapists on site to provide a very holistic

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approach towards recovery.

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So what's the business model?

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Are you a nonprofit entity?

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Are you a for-profit entity?

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Do you leverage insurance?

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Is it cash-based?

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Yeah.

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So we are currently a for-profit entity with current makings of expanding on a national

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level through licensing options of our facility.

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We have a turnkey solution for prospective businesses or existing organizations to be

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able to seamlessly integrate this into their commercial health club location or medical

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fitness facility.

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Or even those that are interested in a freestanding facility option, we do have those opportunities

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as well to license with us.

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We do accept insurance.

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Rather, it's really up to the constructs of the insurance company to requisite believe

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if we are a reimbursable model of care to their standards.

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We have had luck with insurance reimbursement, particularly with the state of California

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and Workman's compensation has been very advantageous to our clients to be able to get full coverage

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of care at our facility.

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Otherwise, we are an out-of-pocket pay facility, a fee-for-service model where clients pay

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hourly as they go.

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You mentioned a turnkey solution that could be implemented within a commercial health

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club.

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Is there unique or specialized adaptive equipment that those facilities would have to purchase

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or add to be able to adopt your model?

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For sure.

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When we say turnkey, we believe that we have both basically the business practices, the

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guidance and the personnel to provide implementation and pre-open at time of startup and on a monthly

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basis thereafter with things like business best practices.

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We have a suite of vendors and suppliers of equipment that can provide the equipment very

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seamlessly per the direction that we give.

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We look at a tenant improvement scope to see how we might orient a facility with whatever

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space we are allotted to best fit the most appropriate equipment.

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Whether or not certain equipment is needed might be up to the discretion of the agreement

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that is made with that particular health club or that person.

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Or we look at the geographics in the area and we ask ourselves, what are the most important

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needs that we must have in this particular orientation of this type of facility to meet

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the demographic needs of the clientele that exist in that area?

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There's negotiation there of what equipment is needed and what is not, but in terms of

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the other kind of business support options that we provide, really it's rooted in education.

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We have a proprietary educational model and certification program that we built in-house

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and a continued education units model that goes along with that.

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So we provide requisite ongoing education to staff members here at our flagship location

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and domestically as we expand to be able to continue to give them cutting edge information

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to be able to best practically treat their clients in a hands-on form.

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We also provide business ongoing support, SEO, referrals, and of course the ongoing

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business measures to be able to ensure success through our 120 hours of hands-on experience

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of best practice in the field over our past 17 years as a company.

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Sounds like you've said that once or twice before.

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I definitely want to touch on the certification in a lot of detail, but one thing before we

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get there, I think one thing that holds some fitness professionals back from including

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more people with disabilities is this idea that they need to drastically overhaul their

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facility or that they need very expensive adaptive equipment to do so.

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Would you, speaking from someone with experience as that adaptive athlete as well as a business

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owner, do you think just a traditional fitness facility could begin to more effectively support

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individuals with disabilities without having to retrofit their entire equipment?

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Not to be easily confirming or cliche, but the most important piece of the puzzle is

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the people, not the equipment.

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We can find adaptability and suitability of existing equipment to provide really the platform

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for somebody to find equitable space within an existing health club, whether boutique

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or commercial.

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We have the component through training and education to provide the inclusive programming

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aspect to integrate with whatever equitability you already have in the form of equipment

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in existing space so you can bring diverse populations to your existing facility.

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They may not require any bit of a tenant improvement or an expansive overhaul of space or comprehensive

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equipment that can get you to the place where you can be operable for the paralysis community.

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Rather, you need to have an open mind with the set of team members that are willing and

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wanting to get trained in the paralysis recovery and rehabilitation sector to be able to take

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those best practices and innovative and creative minds to look at your existing space, your

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existing equipment, and provide the foundational components of our methodology and implement

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that directly into what you already have in your existing space.

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Yeah, that confirms a lot of the stance that I kind of adopt that oftentimes it's a lack

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of education and confidence in supporting people with different abilities than your

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traditional gym member.

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But like you said, the education that you provide can alleviate some of those concerns

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and kind of raise people's knowledge base to be able to support clients with disabilities

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and kind of unique ways with whatever equipment you have access to and whatever space you

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have access to.

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Certainly, and I don't want to call it ignorance, but a lot of people don't know what they don't

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know and I think they've been told things and maybe have bought into that that there's

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no hope for them to adopt something like an inclusive program like this because the

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money association with what's going to hinder the bottom line with such a vast setback and

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where they might incur the ROI.

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But quite honestly, the leap of faith is just taken in the mindset and perspective shift

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of one person raising their hand to say, I want to get trained.

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I want to take on this mantra of really being inclusive in terms of our programmatic options

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that we can provide to clients, creating equitable access beyond just widening doorways and how

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having ramps that are built to code so we can have diverse populations because this

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real pandemic we've been facing is the diversity, equity and inclusion pandemic of the paralysis

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community that never seems to find a way to coexist amongst the able-bodied population

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in the fitness and medical sectors alike.

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So maybe going off of that topic, how do you envision that individuals in the paralysis

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community can seamlessly coexist amongst their peers in a traditional gym environment?

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How do you define inclusion in that regard?

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I think there's many layers and many definitions to inclusion, if we're being honest.

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But as I look at the broad scope of how the world is really trajectory today, naturally

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speaking, we have a lot of these commercial health club change, your bally's total fitness,

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your 24-hour fitness.

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I'm not telling them to redefine the business model to start placating towards a very small

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population in the paralysis community that only represents roughly 5 million people or

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so here in the United States.

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But what if they carved out mindfully, not even just doesn't even have to be four walls,

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but a small space of their commercial setting, a few thousand square feet, maybe less to

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just say we have dedicated space here for inclusion.

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And I think what they would find would be this, and we've seen this case study done

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in real time here in Southern California.

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The perfect step was a part of a commercial health club called the Claremont Club for

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13 years.

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This is a health club that was a private health club home to 10,000 members, 3,400 billable

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units of families and individuals at this health club.

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When we rolled in this particular program into this health club, we saw something literally

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change overnight in one year at this health club where when you talk about employee retention

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and membership attrition, we saw industry lows in that year happen at this commercial

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health club where we fell from 23% down to 13.5% of membership attrition on 3,400 billable

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units.

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So you can see that's about what 8 to 9%.

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So you can do the math.

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We recouped about 300 billable units of members.

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We assumed that that was about a half a million dollars that we were able to recoup in dues

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paying units and then another half a million in non dues revenue for other ancillary services

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that would have been purchased by those members.

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Requisitely speaking, our staff, we had 280 employees at this commercial health club,

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the Claremont club located about 35 miles east of Los Angeles.

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280 employees, our retention rate of those employees in that year fell from 12.5% down

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to 8%.

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It was industry low in the commercial health club industry.

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So we started looking around, we're like, what's going on?

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So we go back to the members and back to the employees.

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We took a broad scale survey and we said, why all of a sudden are you choosing to stay?

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Because mind you, this was also a year for members that we converted to ACH payments,

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which for the older generation was like pulling their hair out.

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They were kind of old school minded thinking.

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So we figured that would run some people off.

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So members come back to fill out the survey and they say, well, you've created a universal

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set of values that I feel like we're doing good for the community and you've created

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a cultural sense in here that feels as if like these are appropriated values I want

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to teach my kids about inclusion and how they can live amongst people that are incurring

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setbacks but they're no different than us.

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They want to coexist with us.

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And then we went to our staff and we said, why are you choosing to stay?

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We get that we're paying fair, but usually we see a larger flux of people looking elsewhere

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for new job opportunities.

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Why did you stay?

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And they said, well, you've created meaning and purpose behind what we do through inclusive

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programming that I feel like we're solving problems in the community rather than just

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talking about them.

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So the Claremont Club in this model, it made money by accident by addressing diversity,

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equity and inclusion by saying, you know what, we're going to do more than just being ADA

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compliant by putting in lifts and putting in elevators and winding doorways.

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Rather, we're going to provide inclusive programming.

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And it was more than just the perfect step as well.

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They created programming for people living with cancer and diabetes and Parkinson's disease

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for recycling for Parkinson's program.

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And it was these programs that literally changed the cultural landscape of this club and they

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made money by accident.

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When you ask me, what does that look like in real time?

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I sense a vision of real diversity in our clubs where we live, walk and work out amongst

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each other.

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And there's opportunities for synergistic movement and cultural change amongst each

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other where there's a person in a chair that's incurring a physical setback that has reveration

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for the person that's able-bodied that's working out across the way from them.

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And there's a sense of hope and motivation by the person that's already able-bodied looking

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at the person in the chair saying, I need to be on it.

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I need to be honoring what I already have.

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So as a collective, we come together and we create the change we want to see in the world.

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Yeah, a lot of good things there.

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I've been writing about the value proposition of inclusion because I think a lot of times

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people associate it with charity.

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They associate it with fiscal sacrifice in place of that purpose.

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But the two aren't mutually exclusive.

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We found, at least in our facility in Massachusetts, that a large percentage of our revenue comes

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from our adaptive athletes.

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And then we create a cause that the rest of our membership really cares about.

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And they feel like their membership is supporting something beyond just themselves.

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So when you go through those periods like COVID, when everyone's getting rid of their

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gym membership and working out at home, our clients continue to support our business because

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they wanted it to exist for our community.

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And I think one of the best ways to kind of normalize inclusion and disability is through

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shared recreation.

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So like you said, that individual in a wheelchair is seeing the able-bodied person training

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alongside them.

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And they're looking up to them and vice versa.

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That able-bodied individual is grateful for the opportunities that they have.

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And maybe it pushes them to work harder and appreciate that more.

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So the value proposition of inclusion is huge.

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And I love that you guys are a for-profit entity because one, it confirms my biases

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that inclusion is not reserved just for charities.

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But two, it's just showcasing that gyms, you don't have to do it as a service of goodwill.

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You can do it as an aspect of good business.

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Love that, Brennan.

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And I think to the for-profit, nonprofit comparative, I actually have and I run and operate and

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founded a not-for-profit entity called the Be Perfect Foundation 17 years ago.

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And I've had a co-conclusive timeline to that of when the perfect step embarked as well.

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And the Be Perfect Foundation is a 501c3 not-for-profit organization that raises funds for the paralysis

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community for fundamental needs, wheelchairs, medical supplies, home and car adaptations,

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participation in exercise-based therapy programs.

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We're a not-for-profit that doesn't have paid staff, 99.9% of every dollar, goes directly

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back to program servicings to serving those in need.

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And we've raised over $9 million over the past 17 years because we identified that the

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for-profit side was solving the inclusive programming, but the affordable access to

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fundamental needs still was not met with what insurance companies would reimburse for.

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So we've kind of cotandently built a two-headed monster not to be self-serving.

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Our reach for the Be Perfect Foundation is very domestic, not just regional.

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And we ensure that there is not a pass-through there just to the perfect step.

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A lot of our program services are completely far and away from the perfect step to individuals

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that have fundamental medical and health needs that are living with varying forms of paralysis.

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So you brought up, is inclusion only held for the not-for-profit sectors?

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In that case, it is, but it's not mutually exclusive to that either.

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Absolutely.

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And we operate Adaptex as a nonprofit for other reasons, non-monetary driven, but then

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our gym operates as a for-profit.

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I was going to ask, as a for-profit entity, you're often serving individuals who post-injury

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might lose employment opportunities, might have socioeconomic situations where they need

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some financial support.

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So how do you balance that, like, charging what the personal trainer is worth, but also

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creating and offering an accessible price point for individuals who are already facing

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in some ways some pretty significant economic challenges?

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Yeah, that is kind of the golden question when you talk about a for-profit model and

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a fee-for-service model with, you know, obviously clients that are already facing financial

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hardships and do part to their setback of their injury and diagnosis.

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So we've actually approached this in a kind of a multifaceted way.

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When we were at the Claremont Club, and I say past tense because we are now in a different

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location, the pandemic unfortunately kind of derailed the Claremont Club's 47-year history

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because of L.A. County guidelines that forced them to close and not find a way to financially

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rebound.

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But when we were there, if you want to talk about real inclusion, the club was hiring

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individuals with disability-oriented backgrounds, and they found positions for them that were

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workably advantageous, whether it was working with the kids in child care and reading to

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them or working at the front desk or working desk jobs or if they were semi-ambulatory,

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maybe it was working in the laundry room or things that you didn't necessarily need to

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be an able-bodied to facilitate, but the club would provide employment to them to help offset

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some of these costs that were associated with therapies.

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And so the other approach that we take is we have a client success team here at the

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Perfect Step where we sit down with every client in our program at time of start in

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our program and we talk about financial planning.

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We talk about fundraising efforts, and we give them blueprints and models of how to

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fundraise and how to implement these financial planning strategies so they can find longevity

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in our program.

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We talk to them about grant writing, we talk about them seeking foundations for foundational

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help.

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And so all of those things tend to move people along the recovery timeline just a little

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bit longer to stay in our program for greater consistency and longer periods of time than

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otherwise they would just fall out of it and be vastly set back in their health measures

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because there's not financial sustainability in a program like this where there's no reimbursable

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cause for care.

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Yeah, that's a really interesting point to kind of have that holistic support where you're

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not necessarily funding their training, but you're pointing them in direction of resources

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that could potentially do so.

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Let's talk about the actual nuts and bolts of the Perfect Step and the training philosophy

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that accompanies it.

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So you guys created the STEP, Certified Paralysis Recovery Specialist Program.

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Can you talk to me a little bit about how that evolved, whether it was something that

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you had from the get-go or whether it was something that was kind of built in tandem

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as you started providing services?

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So the Perfect Step was previously known as a Project Walk franchise facility.

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So Project Walk was an inclusive program option in the chronic stage of recovery that at its

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peak had 18 worldwide locations.

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We were actually in terms of geographics, their closest location to their flagship facility

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of San Diego and Southern California, us being in the Inland Empire, greater Los Angeles

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area.

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So we had for a few years the educational dialect of being able to be educated by Project

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Walk.

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And unfortunately, they closed their doors and we were forced to go through an intellectual

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property rebrand.

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And at this time, we knew that we couldn't have any mutual exclusivity to Project Walk

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any longer and their proprietary information was there.

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So we kind of had to go back to the drawing board to ask ourselves, what are we going

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to do through this rebrand to reestablish continued education and to rebuild the certification

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program under our new vocabulary dialects, under our new acronyms and what have you of

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what we believe in terms of best practice, the most effective methodological training

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approaches should be practically implemented.

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So it was kind of twofold.

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Number one, we reestablished what our methodology and approaches towards recovery and we came

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up with three key components to a methodology that we believe are the most effective means

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to treat individuals with neurological disorders.

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First off is the incorporation of safe and appropriated exercise and to apply exercise

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as a form of medication to clients that are vastly limited due to the assistive device

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of the wheelchair, of the Loftran crutches, of the walker, of the AFO, KFO.

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Those were all intended to be devices that provide stability.

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So when our clients come into our building, we rid them of those particular apparatuses

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because the body is going to ultimately conform to the environment that it's most susceptible

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to.

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So we want to create an environment that is very much true to able bodyism.

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And so if we reduce the susceptibility to these assistive devices, we can get the body

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to heal more in an orientation that's very true to able bodied life.

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And we have expert help in how to train, how to spot, and how to create a safe environment

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in here.

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So we try to get the body to heal away from the assistive device and incorporate exercise

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in an approach of training posturally correct first and anatomics first and through biomechanical

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efficient movements first to induce appropriated healing.

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The second component is load bearing.

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It's widely known that people that aren't up and ambulating as much as that of the able

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body population and very similarly to that, to the geriatric population who see a vast

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reduction in their bone health when they get to a particular age.

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That is very similar to our clients who sit for maybe 13, 14, 15, 16 hours a day.

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And you start to see a lot of those body systems start to slow down, endocrine system, various

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body systems that might be contributive to that of producing calcium and osteocalcin

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to particular parts of the bodies that help ensure the integrity of bone structure.

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And so when we put them into a load bearing environment, not passive by just standing,

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but more active load bearing through ambulation over a treadmill or ambulation over a robotic

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gait training system or getting vertical and doing jumps into a total gym or various apparatuses

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that we have standing on a power plate.

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We can actually try to reduce the effects of osteopenia and osteoporosis by promoting

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appropriated bone health to restart and re-jumpstart those body systems again to start producing

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those biological things to get the body back to an appropriated restoration of health.

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We know clients are going to pursue ulterior interventions of reclassed infusions that

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can ensure bone health or calcium supplements, which aren't really reaching the bloodstream

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as much as we hope.

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So if we can provide more neuromuscular reeducation onto the body to ensure better musculoskeletal

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health, that's going to put the client in a better place to live healthier.

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And then last component is our approach towards reactivation and reorganization of the central

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nervous system.

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We call this pattern neural activity recruitment known as an acronym of PNAR.

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And that is a registered trademark term through the US government that we got backed with

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a lot of our other intellectual property.

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And really this is our approach and our foundational teachings of how we provide input back to

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the body to get the output out of the body that we're looking for.

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So a lot of people are looking at this terms of afferent and efferent signaling in terms

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of input and output into the body.

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So our understanding of the neurologically compromised is that their interpretation of

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input into the body of sensory and proprioceptive stimuli is very inhibited and very altered.

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So our specialists have become very keen experts to know through a multitude of factors how

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they can provide the appropriate stimulus back into the body through a closed chain

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environment and with resistance bearing input into the body to give the body the appropriate

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amount of sensory and proprioceptive information.

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And they do this through an alteration of hand placement, speed of movement, angle of

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movement, positional movement, pain induced movement.

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And in real time to the naked eye this would look like stretching, but we take everything

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that we do when appropriate and we take it from passive to active.

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So what would that mean?

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Passive stretching would just be deep breathing and breathing through to get more appropriate

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ranges of motion and length through particular extensions of muscle groups where we try to

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actively engage the client's central nervous system to recoup motor function output from

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the body to be able to create controlled and volitional movement over time.

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So we're taking an active approach as opposed to passive.

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So what we find is if we can induce this with precision, with repetitiveness over and over

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again the hope is to achieve neuroplasticity to create neuroplastic change and to create

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a new neural pathway so somebody can have more controlled and volitional function again.

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We know that in the able-bodied population to achieve neuroplastic change you need 400

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to 600 repetitions of a particular movement to see that through.

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We understand that that really compounds with the neurological effects of the clients that

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we treat.

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So we've got to be treating people over and over again and with repetitive precision to

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get to that point.

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So that covers the methodology side of things.

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When we talk about what we've created in terms of educational programming, we've built a

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four-tiered structured certification program starting with our entry level level one certification

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which has prerequisite requirements of educational schooling, background and what have you.

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And then there's a 150 hour plus educational program that we put somebody through that's

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conclusive of hands-on experience, shadowing, book work, test taking, lectures, seminars,

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educational work with clients together, real world experience, projects before somebody

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can even work with a client hands-on.

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And then they get this entry level certification, they work with client and then level two is

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the next step up the ladder which you have to incur a certain amount of hands-on hours.

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Other prerequisite requirements, essay writing, programmatic development.

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And then there's a level three certification, again more prerequisite requirements.

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And then our top level and top tier certification is what's called our educator.

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And that is a person who is then qualified to train new people that they comprehensively

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understand our methodology so much that they can re-deliver that education in a format

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where it can be taught and learned.

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So again, this is all conclusive of particular book works, lectures, seminars, test taking.

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We have about 700 pages worth of training and operating manuals that have been copyrighted

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as well.

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And we've built out a digital learning management system and we have a learning management platform

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where we can train people educationally across the country.

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And it also is a multi-tiered digital platform where it also has a digital training component

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to be able to also train clients in remote areas across the country and world as well

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too.

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A lot done back there.

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Did you conduct any sort of like Delphi or expert review of the curriculum?

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Did you collaborate with anyone outside of Perfect Step when you were building these

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00:32:00,600 --> 00:32:01,920
educational materials?

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Yeah.

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So we've kind of had the broad scale influence of some of our healthcare professionals that

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are in the field.

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We have a team of a board of directors of different team of doctors and physiatrists

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as well as general practitioners who kind of have provided facility and educational

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oversight to us.

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We have had some co-collaborative efforts with local rehabilitation hospitals and the

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integration more recently with their licensed skilled therapists to be able to get the necessary

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feedback around what we're doing requisite to find appropriatedness.

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And what we do, but much of our educational formatting and materials in terms of the written

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00:32:43,560 --> 00:32:49,320
content is completely site and sourced from educational journals to really kind of provide

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backing through what we're doing.

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And we also have a research division to what we're doing here at the Perfect Step.

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We have four concurring projects right now of data collection that are going on in house.

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We are in the midst of a massive internal overhaul right now of taking all of our written

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assessments from the past and our evaluations and backdating them and putting them into

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a digital platform where we can get everything digitized.

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00:33:20,720 --> 00:33:26,800
So we'll be able to do research projects on the fly to be able to gather the data that

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validates our effectiveness.

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But I'll give you a past research project that actually just got submitted to journal

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actually just two weeks ago.

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And this was a particular research project that was done in co-tandem with Kaiser Permanente

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and their regional hospital of Fontana here in Southern California.

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And their lead doctor over there, his name is Dr. Robert Salas or Bob Salas.

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And he's also the lead doctor of the National Exercises Medicine Initiative where he's

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trying to get governmental reform to ask doctors to be able to prescribe exercise as a form

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of medication that is reimbursable by insurance company rather than just medication itself.

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00:34:12,040 --> 00:34:20,020
And this doctor has used our particular location as his beta site to show validation of success

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00:34:20,020 --> 00:34:25,400
that programs like ours actually do increase quality of life and reduce secondary health

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00:34:25,400 --> 00:34:28,500
complications that could result in rehospitalization.

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00:34:28,500 --> 00:34:31,720
He saw this with his own two eyes, but he said, you know what?

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00:34:31,720 --> 00:34:36,920
Kaiser Permanente needs to do co-tandem a research project on this to show through data

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that this is true.

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So we did a multi-year study with Kaiser Permanente assessing increased quality of life in our

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00:34:45,080 --> 00:34:49,160
clients and a reduction of secondary health complications, bladder infections, pressure

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00:34:49,160 --> 00:34:56,000
sores, independence levels, heterotrophic ossification, bone density issues.

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00:34:56,000 --> 00:34:58,320
I guess you could say emotional contentment.

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And we looked at these different measures.

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We had 92 different questions that we asked on a Likert scale on a survey over a multi-year

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study.

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The way it was segmented were these questions were asked prior to somebody coming in our

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program, six months after being in our program, one year after being in our program, and two

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years after being in our program to show a barometer of change over time with how our

455
00:35:22,940 --> 00:35:28,140
program has influenced quality of life and secondary health complications.

456
00:35:28,140 --> 00:35:30,160
So we got the outcomes of the study.

457
00:35:30,160 --> 00:35:37,400
91 of our 92 measures came back with a P score value, 0.05 or greater indicating significance

458
00:35:37,400 --> 00:35:41,520
that we're increasing quality of life and reducing secondary health complications.

459
00:35:41,520 --> 00:35:47,400
And this is groundbreaking when you think about the chronic care continuums and exercise-oriented

460
00:35:47,400 --> 00:35:52,660
facilities that have a mindset around activity-based therapy protocols that we're really doing

461
00:35:52,660 --> 00:35:54,760
things beyond the traditional model of care.

462
00:35:54,760 --> 00:36:00,920
Once insurance runs out as a viable continuum to care, that if you're an insurance company,

463
00:36:00,920 --> 00:36:05,620
you should be salivating looking at this thinking like, wait, there's an inclusive program option

464
00:36:05,620 --> 00:36:11,640
out there that can keep our clients healthy and off of our dime of a large hospital bill

465
00:36:11,640 --> 00:36:15,640
racked up because they're deteriorating.

466
00:36:15,640 --> 00:36:17,480
And you know, what's reimbursable?

467
00:36:17,480 --> 00:36:18,480
I don't know.

468
00:36:18,480 --> 00:36:22,800
Maybe it's $10,000, $15,000 a year that they're willing to throw in the hat to say, use this

469
00:36:22,800 --> 00:36:25,600
as you want for whatever care that you like.

470
00:36:25,600 --> 00:36:29,160
And then for clients, it's like, okay, I only have to supplement and offset the difference

471
00:36:29,160 --> 00:36:35,000
of that to then fundraise or make lifestyle changes to stay sustainable and activity-based

472
00:36:35,000 --> 00:36:38,560
therapy program over the years to stay healthy.

473
00:36:38,560 --> 00:36:44,400
And so we feel as if some of these data representations in these research initiatives are really leading

474
00:36:44,400 --> 00:36:49,940
to a place that's going to prove to the world, programmatically speaking, we've got to have

475
00:36:49,940 --> 00:36:55,080
access to these types of programs in major regions across the country so clients have

476
00:36:55,080 --> 00:36:58,520
access to be able to live a healthy life again.

477
00:36:58,520 --> 00:36:59,520
Absolutely.

478
00:36:59,520 --> 00:37:04,040
I think Salus is on a lot of the barriers and facilitators to physical activity for

479
00:37:04,040 --> 00:37:08,920
individuals with disabilities research that I've read.

480
00:37:08,920 --> 00:37:14,720
How can that model that you guys implement be adopted in traditional PT?

481
00:37:14,720 --> 00:37:20,720
And if the outcomes are superior, why has it not been?

482
00:37:20,720 --> 00:37:25,960
Well, you know, I have an immense respect for the licensed skilled therapists.

483
00:37:25,960 --> 00:37:30,880
So for me, there's not really a naysayership around what they're doing or what they shouldn't

484
00:37:30,880 --> 00:37:31,880
be doing.

485
00:37:31,880 --> 00:37:37,240
I think where they exist in the continuum of care, they really provide an approach that

486
00:37:37,240 --> 00:37:42,040
prepares people for life transition back to home.

487
00:37:42,040 --> 00:37:49,760
They give them the requisite knowledge, skills, education, and techniques to be able to occupationally

488
00:37:49,760 --> 00:37:55,680
adapt to activities of daily living that are probably much more needed at that moment in

489
00:37:55,680 --> 00:38:03,760
somebody's recovery trajectory than what we offer in terms of intense activity and exercise.

490
00:38:03,760 --> 00:38:05,800
And so I understand where they're coming from.

491
00:38:05,800 --> 00:38:12,360
The traditional model of care has to adhere to a billable units model of care where they

492
00:38:12,360 --> 00:38:22,320
have to show particular beneficial quantitative measures of increase in KPIs that show progress.

493
00:38:22,320 --> 00:38:27,040
And so their approach much of the time is to focus on the areas of the body that already

494
00:38:27,040 --> 00:38:33,120
have instilled function because then it becomes really a strength training program of what

495
00:38:33,120 --> 00:38:37,360
volition is already there and you're really compounding on that.

496
00:38:37,360 --> 00:38:42,320
We really take the approach adversely to work from the ground up as opposed to the top down.

497
00:38:42,320 --> 00:38:47,520
Also, I mean, you could throw central cord injuries out of the way when they heal differently,

498
00:38:47,520 --> 00:38:51,600
but we focus on the areas of the body that don't have instilled function and we try to

499
00:38:51,600 --> 00:38:55,020
reactivate and reorganize the central nervous system there.

500
00:38:55,020 --> 00:38:59,760
And I won't say first because there is kind of a balance of symmetry where we work on

501
00:38:59,760 --> 00:39:04,600
both, but we're not just acknowledging the areas of the body that already have instilled

502
00:39:04,600 --> 00:39:09,280
function and we're not going to just work on slideboard transfer and technique a hundred

503
00:39:09,280 --> 00:39:10,840
times over again.

504
00:39:10,840 --> 00:39:12,680
Do we find valuability in that?

505
00:39:12,680 --> 00:39:13,680
Yes.

506
00:39:13,680 --> 00:39:19,120
But we look at the other intrinsic parts of the body that are required to be able maybe

507
00:39:19,120 --> 00:39:21,200
to facilitate that activity of daily living.

508
00:39:21,200 --> 00:39:24,340
Okay, if somebody wants to slideboard, we don't just need to work on technique.

509
00:39:24,340 --> 00:39:25,340
What else is needed?

510
00:39:25,340 --> 00:39:26,340
Okay.

511
00:39:26,340 --> 00:39:32,880
Shoulder stabilization and shoulder griggles, extension at the triceps, better stability

512
00:39:32,880 --> 00:39:37,480
through the core muscling so we can get more on top of the hips to relieve the issues of

513
00:39:37,480 --> 00:39:39,800
all the load that they're receiving.

514
00:39:39,800 --> 00:39:44,440
Is the client able to take any of the load down and in through the feet so they become

515
00:39:44,440 --> 00:39:48,000
kind of a lot a lighter mass to slide across the board.

516
00:39:48,000 --> 00:39:54,160
So we're going to work on all of those things from that perspective more holistically.

517
00:39:54,160 --> 00:40:00,480
So in terms of the adoption from the traditionalized community to take this on, I don't see it

518
00:40:00,480 --> 00:40:01,480
happening.

519
00:40:01,480 --> 00:40:02,480
I don't expect it to happen.

520
00:40:02,480 --> 00:40:08,200
I think that's why both Continuums of Care can and should coexist.

521
00:40:08,200 --> 00:40:09,640
Both have valuability.

522
00:40:09,640 --> 00:40:15,080
I believe both have proven to show that they can be successful and create the KPIs that

523
00:40:15,080 --> 00:40:16,320
matter.

524
00:40:16,320 --> 00:40:21,520
I just personally tend to think that in the chronic long-term stage of recovery, we need

525
00:40:21,520 --> 00:40:27,960
to get to these optimal stages of KPI indicators of health measures that keep people out of

526
00:40:27,960 --> 00:40:29,840
the hospital.

527
00:40:29,840 --> 00:40:33,920
That's the last thing that a person in the long stage of recovery wants to find themselves

528
00:40:33,920 --> 00:40:34,920
back in again.

529
00:40:34,920 --> 00:40:35,920
Yeah.

530
00:40:35,920 --> 00:40:41,880
It's also like it doesn't necessarily have to be implemented within the therapeutic setting,

531
00:40:41,880 --> 00:40:42,880
right?

532
00:40:42,880 --> 00:40:49,240
The recovery process, as you refer to a chronic stage where there might really be no endpoint

533
00:40:49,240 --> 00:40:56,800
of recovery, but there has to be a transition from initial rehabilitation to reintegration

534
00:40:56,800 --> 00:40:58,400
within your community, right?

535
00:40:58,400 --> 00:41:04,480
And traditional gyms can provide that if their staff have the knowledge base and the willingness

536
00:41:04,480 --> 00:41:05,480
to do so.

537
00:41:05,480 --> 00:41:12,480
So I think, and I don't mean to imply that or recommend a path forward, but your model

538
00:41:12,480 --> 00:41:14,640
doesn't have to go to the hospital.

539
00:41:14,640 --> 00:41:17,480
It doesn't have to go to the physical therapy clinic.

540
00:41:17,480 --> 00:41:22,280
It can be that next step towards an individual's recovery process.

541
00:41:22,280 --> 00:41:26,800
I think you more eloquently said that than I probably could have formed in my long-windedness,

542
00:41:26,800 --> 00:41:29,640
but I think that's a very appropriate thought.

543
00:41:29,640 --> 00:41:30,640
Yeah.

544
00:41:30,640 --> 00:41:31,640
Yeah.

545
00:41:31,640 --> 00:41:39,240
Are there some levels of SEI that respond more favorably than others to this model of training?

546
00:41:39,240 --> 00:41:45,480
I think where we really are challenged is the lower motor neuron injuries.

547
00:41:45,480 --> 00:41:53,080
People that really have a disdain function in their lower extremities because of such

548
00:41:53,080 --> 00:42:00,440
a severe injury where there's no apparent spasticity or tone.

549
00:42:00,440 --> 00:42:06,800
There's no apparent response to even deep functional electrical stimulation pulse.

550
00:42:06,800 --> 00:42:13,880
That creates real challenges for us to get neurologically a signal to particular parts

551
00:42:13,880 --> 00:42:20,200
of the body to activate a controlled and volitional or even non-volitional contraction to get muscle

552
00:42:20,200 --> 00:42:27,440
integration in the muscle belly that can promote musculature, that can promote continued sensation.

553
00:42:27,440 --> 00:42:33,160
So that is still something that those severe injuries we become very challenged with.

554
00:42:33,160 --> 00:42:37,360
They still have other therapeutic properties that can be approached and influenced in terms

555
00:42:37,360 --> 00:42:42,680
of the load bearing aspects, in terms of the other holistic aspects, but where we find

556
00:42:42,680 --> 00:42:51,040
real bread and butter in what we do, I would say people that really have gotten to a place

557
00:42:51,040 --> 00:42:58,480
of being able to have some functionality to be able to fire particular muscle groups,

558
00:42:58,480 --> 00:43:02,520
if not isolated movements in the lower extremities.

559
00:43:02,520 --> 00:43:06,680
I think that goes without saying anybody would say, oh, you're saying that people who are

560
00:43:06,680 --> 00:43:10,040
already walking already have movement, you can get walking like wallah.

561
00:43:10,040 --> 00:43:11,040
What a big deal that is.

562
00:43:11,040 --> 00:43:16,080
No, I think there's some repetitiveness to that, that we can take somebody who's even

563
00:43:16,080 --> 00:43:20,440
on the brink to that point and maybe people who are already gait training.

564
00:43:20,440 --> 00:43:23,680
It's not enough for us to just look at and say, oh, they're gait training.

565
00:43:23,680 --> 00:43:24,680
That's great.

566
00:43:24,680 --> 00:43:26,720
How do we refine the gait pattern?

567
00:43:26,720 --> 00:43:29,360
What does the swing phase look like with perception?

568
00:43:29,360 --> 00:43:35,360
What does heel off look like and toe off look like with actual precision?

569
00:43:35,360 --> 00:43:39,540
And really breaking down the gait pattern to not just say, oh, it's just enough that

570
00:43:39,540 --> 00:43:44,120
you toe drag, how do we create appropriated mechanics to that?

571
00:43:44,120 --> 00:43:49,120
But when we look at cervical level spinal cord injuries in particular, they tend to

572
00:43:49,120 --> 00:43:54,680
present with a lot of opportunities for healing, mainly because they also have opportunities

573
00:43:54,680 --> 00:44:03,480
in upper body for healing, for muscle work, for stability based work, for reorientation

574
00:44:03,480 --> 00:44:07,900
of reactivation and reorganization of the central nervous system.

575
00:44:07,900 --> 00:44:12,240
They need functionality work, they need coordination work, balance and stability work, not just

576
00:44:12,240 --> 00:44:16,660
in lower extremities, but through the mid part and through the core.

577
00:44:16,660 --> 00:44:21,180
So there's a lot of varying approaches we can take with cervical level spinal cord injuries

578
00:44:21,180 --> 00:44:26,920
that really adds to kind of the complexities of what we provide.

579
00:44:26,920 --> 00:44:32,380
And we find that a lot of our cervical level injuries really are highly motivated because

580
00:44:32,380 --> 00:44:37,000
they don't have their upper body or their lower body working for them, so to speak,

581
00:44:37,000 --> 00:44:42,420
at the capacity that would be really advantageous to living a very independent life.

582
00:44:42,420 --> 00:44:47,000
So they're highly motivated to work on the entire body to get back to a place of optimal

583
00:44:47,000 --> 00:44:48,000
health.

584
00:44:48,000 --> 00:44:53,840
And this isn't really a nayshare shift towards thoracic or lumbar level injuries to say

585
00:44:53,840 --> 00:44:59,360
they're unmotivated, but we have found sometimes there's a little bit more contentment that

586
00:44:59,360 --> 00:45:05,040
they are already living very feasibly a life that is very fluid in terms of living on their

587
00:45:05,040 --> 00:45:11,060
own that sometimes their orientation of what they want out of their recovery might be different

588
00:45:11,060 --> 00:45:15,320
than just focusing on lower extremity leg work.

589
00:45:15,320 --> 00:45:22,940
But I think our program and our methodology can lend itself to be beneficial to a lot

590
00:45:22,940 --> 00:45:23,940
of different people.

591
00:45:23,940 --> 00:45:29,020
And it's not just a promise of saying, hey, if you come here and you work out, we'll get

592
00:45:29,020 --> 00:45:30,700
you back controlled and volitional movement.

593
00:45:30,700 --> 00:45:32,680
These are things that we can't promise.

594
00:45:32,680 --> 00:45:38,000
What we can promise is that if you stay consistent with this and committed to this over time,

595
00:45:38,000 --> 00:45:40,640
you will become a healthier individual of yourself.

596
00:45:40,640 --> 00:45:45,580
A lot of things that we might see in our clients that really matter to us the most are they

597
00:45:45,580 --> 00:45:47,580
lose weight.

598
00:45:47,580 --> 00:45:53,640
They become more functional in activities of daily living because they become more stable

599
00:45:53,640 --> 00:46:00,220
and a lot stronger to be able to reach, grab, manipulate things.

600
00:46:00,220 --> 00:46:06,740
We see more than anything the self identity complex change.

601
00:46:06,740 --> 00:46:12,460
People become more confident beings comfortable in their skin.

602
00:46:12,460 --> 00:46:17,500
They want to get back out and integrate with society and people again.

603
00:46:17,500 --> 00:46:26,900
They find the wherewithal to say amid my circumstances, I'm going to go live again.

604
00:46:26,900 --> 00:46:31,420
In living is a verb, it's an action, but it's an action that starts in the mind.

605
00:46:31,420 --> 00:46:38,340
And for us, when we see that outside of our four walls, that is almost sweeter and a better

606
00:46:38,340 --> 00:46:43,300
response to recovery than physical recovery itself.

607
00:46:43,300 --> 00:46:50,420
Because the likelihood of somebody getting back to that picturesque life of living life

608
00:46:50,420 --> 00:46:55,500
fluidly as they knew it physically with perfect ambulation, the opportunity to do all the

609
00:46:55,500 --> 00:47:01,460
things they once did probably isn't a sense of realism, but just because life is different

610
00:47:01,460 --> 00:47:06,540
and the how you do things is different doesn't mean it can't be better.

611
00:47:06,540 --> 00:47:10,380
And it's the lens that you're looking through in the mindset that you take with that to

612
00:47:10,380 --> 00:47:14,380
live under your new circumstances that will set you free.

613
00:47:14,380 --> 00:47:20,860
And for our clients coming into our four walls, finding community, finding a network, finding

614
00:47:20,860 --> 00:47:28,500
people they trust to facilitate our methodological practices onto them, that is what they need

615
00:47:28,500 --> 00:47:35,100
more than anything on a social level to heal spiritually, mentally, and emotionally before

616
00:47:35,100 --> 00:47:36,960
they even do physically.

617
00:47:36,960 --> 00:47:42,320
We know that the body's physical state of healing starts with healing in the mind first.

618
00:47:42,320 --> 00:47:46,220
So if we can start with healing here, the body's an instrument of the mind, likely the

619
00:47:46,220 --> 00:47:47,860
body will follow.

620
00:47:47,860 --> 00:47:52,500
Yeah, you mentioned that living looks different for everyone and in these different stages

621
00:47:52,500 --> 00:47:59,220
of life and people with varying injuries have varying degrees of motivation and goals.

622
00:47:59,220 --> 00:48:09,940
How do you balance that desire to be more able bodied versus be content with your current

623
00:48:09,940 --> 00:48:10,940
state?

624
00:48:10,940 --> 00:48:16,840
Like, you don't want to diminish someone's goals to walk again, but do you have those

625
00:48:16,840 --> 00:48:22,520
conversations with them where you say, yeah, maybe that's not the best use of your time.

626
00:48:22,520 --> 00:48:27,340
Maybe we should work on other aspects that make you more quote unquote functional in

627
00:48:27,340 --> 00:48:30,220
your new form of ADLs.

628
00:48:30,220 --> 00:48:37,060
I think we need to really insinuate a better understanding from an emotional level, somebody's

629
00:48:37,060 --> 00:48:42,100
attachment to contentment and complacency because they're very different.

630
00:48:42,100 --> 00:48:49,080
We're not asking our clients to find complacency with, hey, you may never walk again, but we

631
00:48:49,080 --> 00:48:56,620
are asking them to find acceptance and contentment in the fact that even if you don't, it doesn't

632
00:48:56,620 --> 00:48:58,140
mean you failed.

633
00:48:58,140 --> 00:49:05,420
Like the barometer, so to speak, of success around if somebody's recovered with optimal

634
00:49:05,420 --> 00:49:10,460
success is dictated of, oh, well, that person's walking, so they must have really busted their

635
00:49:10,460 --> 00:49:11,460
tail.

636
00:49:11,460 --> 00:49:18,420
They must have really worked hard to get back up on their feet and they deserve an award

637
00:49:18,420 --> 00:49:24,140
show and we should just honor them and all these people that didn't walk, try a little

638
00:49:24,140 --> 00:49:25,380
harder next time, buddy.

639
00:49:25,380 --> 00:49:30,220
You must not have done the things the right way or the right things.

640
00:49:30,220 --> 00:49:34,700
I'm also not trying to discredit or diminish the walking people that have walked away from

641
00:49:34,700 --> 00:49:35,700
this.

642
00:49:35,700 --> 00:49:37,220
They should be celebrated.

643
00:49:37,220 --> 00:49:39,220
They should be applauded.

644
00:49:39,220 --> 00:49:43,820
And I do know this, if you do nothing, nothing will happen.

645
00:49:43,820 --> 00:49:50,660
But there is some extraneous circumstances that for the things that are out of our control,

646
00:49:50,660 --> 00:49:56,860
sometimes walking because of the severity of your injury might not be in the cards until

647
00:49:56,860 --> 00:50:03,740
an ulterior intervention of technologies that are coming to the forefront now that are intervening

648
00:50:03,740 --> 00:50:08,700
on your life might be needed as a supplement to get you there.

649
00:50:08,700 --> 00:50:16,140
But in the meantime, if you are going to find complete complacency in this idea that if

650
00:50:16,140 --> 00:50:21,540
I just do nothing, I can just wait around for these interventions to come or a cure

651
00:50:21,540 --> 00:50:24,500
to come and I'll be able to just act on that.

652
00:50:24,500 --> 00:50:26,340
That's not how it works either.

653
00:50:26,340 --> 00:50:31,140
Like you've got to be doing something between the here and now and then to prepare your

654
00:50:31,140 --> 00:50:36,260
body to even be a candidate that can raise your hands that says, Hey, I'm an approved

655
00:50:36,260 --> 00:50:41,860
candidate because my blood pressure is intact because I've relieved myself from the tet

656
00:50:41,860 --> 00:50:50,060
hose and the stockings because I've practiced my pulmonary system and my circulatory system

657
00:50:50,060 --> 00:50:53,140
by constantly being in a state of motion.

658
00:50:53,140 --> 00:50:59,540
I challenge my bone density to increase it by not only taking supplements and doing reclass

659
00:50:59,540 --> 00:51:04,860
infusions and taking calcium supplements, but I've re-jump started my biological processes

660
00:51:04,860 --> 00:51:11,140
of my body systems by putting musculoskeletal load onto my body by being in an active load

661
00:51:11,140 --> 00:51:12,820
bearing environment.

662
00:51:12,820 --> 00:51:14,660
I've challenged my bone health.

663
00:51:14,660 --> 00:51:19,540
I've challenged the limber state of my body through ranges of motion and through active

664
00:51:19,540 --> 00:51:25,080
orientations of exercise based therapy and an activity based therapy approach that has

665
00:51:25,080 --> 00:51:28,420
prepared me to be a candidate for what's to come next.

666
00:51:28,420 --> 00:51:35,860
So there's advantageous things along the way, but let's not get remissed at the idea that

667
00:51:35,860 --> 00:51:41,620
of course for all of us that are catastrophically set back the Holy grail and the end all be

668
00:51:41,620 --> 00:51:43,420
all is to walk again.

669
00:51:43,420 --> 00:51:44,420
Of course.

670
00:51:44,420 --> 00:51:49,820
I mean, we all want to live the abled life that we once knew or for some people that

671
00:51:49,820 --> 00:51:51,900
they never knew.

672
00:51:51,900 --> 00:51:59,820
But that doesn't define who you are as much as your ability to take whatever hand you're

673
00:51:59,820 --> 00:52:05,260
dealt and play those cards the best that you can.

674
00:52:05,260 --> 00:52:10,460
And I think we think that the hand we're dealt dictates who we are.

675
00:52:10,460 --> 00:52:14,780
We're really what dictates who we are is how well we play that hand.

676
00:52:14,780 --> 00:52:22,080
So for some living is only defined whether you're walking or not and others they see

677
00:52:22,080 --> 00:52:25,580
the writing on the wall that they can live amid the circumstances.

678
00:52:25,580 --> 00:52:30,960
They can find comfortability in their skin that they can still be a world-class athlete

679
00:52:30,960 --> 00:52:35,280
that maybe does it from a chair that maybe they can be a business entrepreneur that they

680
00:52:35,280 --> 00:52:40,440
can still be a father that they can still be a best friend that they can still be anything

681
00:52:40,440 --> 00:52:44,560
they want to be the mode of doing things is different.

682
00:52:44,560 --> 00:52:50,140
But what they do doesn't have to be and the value orientation is still there.

683
00:52:50,140 --> 00:52:56,380
And I tell people all the time they're like, I just I miss walking again.

684
00:52:56,380 --> 00:53:03,740
And I'm like, I understand to degree, but I'm like, let me ask you something.

685
00:53:03,740 --> 00:53:11,660
The things that you did that you miss in your life, the memories that you hold, maybe it

686
00:53:11,660 --> 00:53:14,500
was a trip.

687
00:53:14,500 --> 00:53:20,500
Your association with that memory of what you miss when you close your eyes and you

688
00:53:20,500 --> 00:53:26,260
think of that image of that memory, does your mind really go to first you walking in that

689
00:53:26,260 --> 00:53:27,260
moment?

690
00:53:27,260 --> 00:53:33,100
No, usually it's what you see outside of you.

691
00:53:33,100 --> 00:53:34,860
Maybe it was a mountain landscape.

692
00:53:34,860 --> 00:53:37,180
Maybe it was a historical monument.

693
00:53:37,180 --> 00:53:38,920
Maybe it was the people.

694
00:53:38,920 --> 00:53:43,780
Maybe it was the internal feeling that you felt in that moment.

695
00:53:43,780 --> 00:53:50,620
And I said, so maybe you need to get back to seeking again the feeling associated with

696
00:53:50,620 --> 00:53:56,840
whatever that moment was and not the act of what it was because we can duplicate those

697
00:53:56,840 --> 00:53:59,100
feelings in different way.

698
00:53:59,100 --> 00:54:07,020
If you told me that, oh, I felt freedom with walking, you can feel freedom in adapted skiing.

699
00:54:07,020 --> 00:54:10,140
You can feel freedom in travel.

700
00:54:10,140 --> 00:54:13,180
You can feel freedom in getting back behind the wheel again.

701
00:54:13,180 --> 00:54:15,780
Like I can show you how to find freedom again.

702
00:54:15,780 --> 00:54:21,780
Oh, I felt X. I can show you how to feel excitement again.

703
00:54:21,780 --> 00:54:24,340
Like we can duplicate those feelings.

704
00:54:24,340 --> 00:54:28,980
So maybe the real attachment is to the feelings and not to the legs.

705
00:54:28,980 --> 00:54:35,300
We've got to change our lens on what we really are longing for again.

706
00:54:35,300 --> 00:54:42,700
You mentioned one portion of your methodology is to remove the assistive tech that an individual

707
00:54:42,700 --> 00:54:44,620
uses.

708
00:54:44,620 --> 00:54:47,180
Has there been any resistance to that?

709
00:54:47,180 --> 00:54:51,900
Does this idea of trying to make someone more quote unquote able-bodied get met with any

710
00:54:51,900 --> 00:54:53,020
resistance?

711
00:54:53,020 --> 00:55:01,220
It's diminishing their new situation and is it ableist in any way to assume that they

712
00:55:01,220 --> 00:55:05,300
have to move towards this new form of movement?

713
00:55:05,300 --> 00:55:09,340
Yeah, I think this is an important moment for me to clarify.

714
00:55:09,340 --> 00:55:11,440
We are very pro technology.

715
00:55:11,440 --> 00:55:12,440
No question about it.

716
00:55:12,440 --> 00:55:15,380
I mean, I don't mean to name drop.

717
00:55:15,380 --> 00:55:19,940
We have a cutting edge piece of virtual reality equipment in here that we just partnered with

718
00:55:19,940 --> 00:55:21,900
the company that I've signed an NDA.

719
00:55:21,900 --> 00:55:25,420
I can't speak on the company's name, but they're bringing it to market and they're

720
00:55:25,420 --> 00:55:27,740
conducting clinical trials here right now.

721
00:55:27,740 --> 00:55:30,940
We have a geo system in here with the robotic gate training.

722
00:55:30,940 --> 00:55:35,500
We have five functional electrical stimulation device through RTI.

723
00:55:35,500 --> 00:55:40,260
We have an overground walking treadmill called the Robo Medica.

724
00:55:40,260 --> 00:55:41,940
We have track systems.

725
00:55:41,940 --> 00:55:45,740
We believe in those ulterior supplemental technological interventions.

726
00:55:45,740 --> 00:55:51,460
We actually have built out a holistic recovery room with all these broad scale technological

727
00:55:51,460 --> 00:55:56,100
interventions as well to supplement what we do in the form of cryotherapy, hyperbaric

728
00:55:56,100 --> 00:56:02,020
chamber, infrared sonar, water massage therapy, Beamer technology, Nano V technology.

729
00:56:02,020 --> 00:56:03,500
We are pro technology.

730
00:56:03,500 --> 00:56:10,300
However, we do believe that your opportunities to use those assistive devices you're going

731
00:56:10,300 --> 00:56:14,620
to use around the clock once you leave the building because they provide a safety measure

732
00:56:14,620 --> 00:56:17,500
to your life that we also believe in too.

733
00:56:17,500 --> 00:56:23,500
We don't want you to leave here and say, hey, go walk recklessly without your AFO and KFO,

734
00:56:23,500 --> 00:56:29,140
roll an ankle, have a non-stable hip fall, hurt yourself.

735
00:56:29,140 --> 00:56:30,740
That's not the goal.

736
00:56:30,740 --> 00:56:36,300
But while you're in here, you have an hour or two hours time with supplemental expert

737
00:56:36,300 --> 00:56:44,900
help that if you had an AFO on, it's providing stability to the ankle region.

738
00:56:44,900 --> 00:56:49,460
Your ankle doesn't planar adorcephalic as effectively with that on.

739
00:56:49,460 --> 00:56:53,140
Laterally speaking, the ankle can't get to circumduction, inversion, eversion.

740
00:56:53,140 --> 00:56:54,140
It's stabilized.

741
00:56:54,140 --> 00:57:00,780
So in here, if we take that off, we can work on getting to better ranges of load in the

742
00:57:00,780 --> 00:57:06,500
gastroc or really challenging the tibialis anterior, applying functional electrical stimulation

743
00:57:06,500 --> 00:57:10,620
technology to those areas unless you have a lower motor neuron injury and you're not

744
00:57:10,620 --> 00:57:12,940
really responding to that.

745
00:57:12,940 --> 00:57:17,860
So we can influence those really intrinsic muscle groups to get them to fire again because

746
00:57:17,860 --> 00:57:21,540
otherwise if you just have that stability there the whole time, they're going to sit

747
00:57:21,540 --> 00:57:22,540
idle.

748
00:57:22,540 --> 00:57:27,740
I mean, look at a wheelchair and what it provides in the form of a 14-inch backrest in my case,

749
00:57:27,740 --> 00:57:33,980
a contoured ergo seat that provides a deep bucket for me to be further stabilized and

750
00:57:33,980 --> 00:57:35,980
a platform for my feet.

751
00:57:35,980 --> 00:57:40,020
I'm really not challenged but a little bit through my core and the innervation of my

752
00:57:40,020 --> 00:57:45,100
core muscles to sit here with balance and stability because the chair is doing that

753
00:57:45,100 --> 00:57:46,180
for me.

754
00:57:46,180 --> 00:57:51,500
So if we take them out of the wheelchair and we train in a posturally correct state and

755
00:57:51,500 --> 00:57:56,580
we work on, okay, to sit in a wheelchair more effectively to get to better posture, we've

756
00:57:56,580 --> 00:58:01,740
got to work on rhomboid contraction, scapular contraction and decompression.

757
00:58:01,740 --> 00:58:07,220
We got to work on not just shrugging shoulders but getting to a state of depression to get

758
00:58:07,220 --> 00:58:09,260
the better postural pedics.

759
00:58:09,260 --> 00:58:13,780
How do we get to a place where we get better rotational movement so we can work through

760
00:58:13,780 --> 00:58:18,860
the three planes of motion that are often inhibited through a wheelchair and we have

761
00:58:18,860 --> 00:58:24,740
expert help and sufficient spotting to provide safety measures while clients in here?

762
00:58:24,740 --> 00:58:29,540
And then as we evaluate where somebody's at in the recovery continuum and in an appropriate

763
00:58:29,540 --> 00:58:38,100
timeline, we can look at that and say, okay, now let's apply the technological supplemental

764
00:58:38,100 --> 00:58:44,860
advances that can really help and supplement what a client needs now to succeed with what

765
00:58:44,860 --> 00:58:48,300
we can't do as specialists.

766
00:58:48,300 --> 00:58:51,460
So those times do come.

767
00:58:51,460 --> 00:58:57,380
If someone is interested in these topics or they pique someone's curiosity, what background

768
00:58:57,380 --> 00:59:03,220
do they need and how could they go about learning from the perfect step?

769
00:59:03,220 --> 00:59:04,220
Great.

770
00:59:04,220 --> 00:59:05,220
Yeah.

771
00:59:05,220 --> 00:59:10,860
So for our specialist position, and I'd say that is maybe the most sought after position

772
00:59:10,860 --> 00:59:18,060
to be able to have the one-on-one working experience with our clients, we require a

773
00:59:18,060 --> 00:59:24,180
four-year degree in something relating to the human body, exercise physiology, exercise

774
00:59:24,180 --> 00:59:32,760
science, kinesiology, movement, sports science, even human biology are kind of appropriated.

775
00:59:32,760 --> 00:59:36,620
At that point, we can provide the ongoing education to get them appropriately trained.

776
00:59:36,620 --> 00:59:42,260
But I would say beyond the educational background, we care more about an individual's passion

777
00:59:42,260 --> 00:59:44,660
and purpose for what we do.

778
00:59:44,660 --> 00:59:50,340
Like that writing is on the wall in an interview process with somebody of, are they here from

779
00:59:50,340 --> 00:59:54,700
a transactional sense that this is a job for them or are they here because they want this

780
00:59:54,700 --> 00:59:56,640
to be a career?

781
00:59:56,640 --> 01:00:01,340
And we don't mean that so much with literacy as much as we do figuratively.

782
01:00:01,340 --> 01:00:05,860
We want somebody to be in the mindset that we don't want you to think about this in terms

783
01:00:05,860 --> 01:00:07,400
of the short term.

784
01:00:07,400 --> 01:00:12,380
We want a long-term commitment because the sustainability of our program and how our

785
01:00:12,380 --> 01:00:17,460
program has been built has been off of the creed that we've had a group of individuals

786
01:00:17,460 --> 01:00:23,380
that have found continued benefit in upping the ante of their practicality of their work

787
01:00:23,380 --> 01:00:25,540
through their past experiences.

788
01:00:25,540 --> 01:00:30,380
That is what's made an All-Star team here at our flagship location of individuals that

789
01:00:30,380 --> 01:00:32,860
have well over 8,000 hours.

790
01:00:32,860 --> 01:00:37,740
We have an individual that has over 16,000 hours of experience in this field.

791
01:00:37,740 --> 01:00:42,460
And as a collective right now, our current staff over 70,000 hours of experience and

792
01:00:42,460 --> 01:00:47,500
as a collective over the history of our company over 120,000 hours of experience, all of that

793
01:00:47,500 --> 01:00:52,960
information continues to get refunded back into here of a sharing of best practices.

794
01:00:52,960 --> 01:00:58,540
And we're constantly looking for individuals that are cutting edge, that are highly motivated,

795
01:00:58,540 --> 01:01:02,060
but people that are fueled by passion and purpose before they are money.

796
01:01:02,060 --> 01:01:04,020
The money will come as a byproduct of this.

797
01:01:04,020 --> 01:01:07,300
Like you should get paid for what you do well.

798
01:01:07,300 --> 01:01:11,380
You know, we completely understand that too, but lead with passion and purpose to make

799
01:01:11,380 --> 01:01:13,820
a difference and the rest will fall into place.

800
01:01:13,820 --> 01:01:14,820
Absolutely.

801
01:01:14,820 --> 01:01:20,820
But what if someone's in, for example, Massachusetts, they aren't near a perfect step.

802
01:01:20,820 --> 01:01:27,220
They don't have any prospective clients with an SEI or with CP or post stroke.

803
01:01:27,220 --> 01:01:29,100
How can they get started?

804
01:01:29,100 --> 01:01:37,060
Yeah, I would say, you know, the perfect step doesn't have to be the end all be all.

805
01:01:37,060 --> 01:01:42,180
You know, there's other great agencies out there that do offer opportunities for continued

806
01:01:42,180 --> 01:01:44,300
education and learning.

807
01:01:44,300 --> 01:01:48,660
You know, there's a couple of different firms out of Florida that will offer this, you know,

808
01:01:48,660 --> 01:01:53,060
your local rehab hospitals, but let's just say this is perfect step specific.

809
01:01:53,060 --> 01:01:58,140
We actually offer virtual training programs to people in remote parts of the country or

810
01:01:58,140 --> 01:02:03,060
the world where we can train them in a remote sense, or we even offer a hybrid option.

811
01:02:03,060 --> 01:02:06,120
You can fly in for a week or two at a time.

812
01:02:06,120 --> 01:02:09,940
We would train you and then you would take that information home and we'd have follow

813
01:02:09,940 --> 01:02:14,460
up supplemental training and that would give you the opportunity to have the diversity

814
01:02:14,460 --> 01:02:20,020
of needs that are met in terms of your educational needs to be able to take that and then apply

815
01:02:20,020 --> 01:02:24,820
that to the populations that we identify this is applicable towards.

816
01:02:24,820 --> 01:02:29,780
So there is a multitude of options that we can make work.

817
01:02:29,780 --> 01:02:35,500
We don't intend to hoard education, nor do we intend to think that we believe we're the

818
01:02:35,500 --> 01:02:37,100
one stop shop for education.

819
01:02:37,100 --> 01:02:42,020
I mean, my gosh, we know, you know, this much about this much in the world.

820
01:02:42,020 --> 01:02:46,060
We can also be learning from the licensed skilled therapists, from the doctors, from

821
01:02:46,060 --> 01:02:51,500
the educators, from the practitioners, from the journalists, from the researchers, like

822
01:02:51,500 --> 01:02:56,620
we've all got to come together at some point and say, egos aside, I don't need to be the

823
01:02:56,620 --> 01:03:00,700
guy holding the golden egg, but how do we all come together to share in best practice

824
01:03:00,700 --> 01:03:04,780
to then take that information and give it directly back to the clients who are the most

825
01:03:04,780 --> 01:03:08,700
important people in this equation so they have a betterment in their life.

826
01:03:08,700 --> 01:03:14,460
So what ask yourself passion and purpose first and if the perfect step fits your mold, we

827
01:03:14,460 --> 01:03:16,820
have those options for education for you.

828
01:03:16,820 --> 01:03:21,460
You can even start by turning it tuning into podcasts like this.

829
01:03:21,460 --> 01:03:27,620
You're going to have opportunities to learn from great medical professionals, organizations,

830
01:03:27,620 --> 01:03:31,420
businesses that are trying to find their way.

831
01:03:31,420 --> 01:03:34,980
The perfect step has their own podcast, not to be co-competitive.

832
01:03:34,980 --> 01:03:40,020
It's called pathways to healing where we have medical professionals and fitness professionals

833
01:03:40,020 --> 01:03:45,060
on our podcast to share an education about their experiences as well as clients who share

834
01:03:45,060 --> 01:03:46,580
client stories.

835
01:03:46,580 --> 01:03:50,700
And maybe your best form of education that you can go seek is directly through the clients

836
01:03:50,700 --> 01:03:51,700
themselves.

837
01:03:51,700 --> 01:03:58,260
You want to practice real inclusion, go talk to them, sharing story with them, ask them

838
01:03:58,260 --> 01:04:04,140
about their experiences, ask them about the best practices that were most effective, getting

839
01:04:04,140 --> 01:04:06,820
them closer to the life that they want to live.

840
01:04:06,820 --> 01:04:09,180
And maybe that will give you an idea of where to start.

841
01:04:09,180 --> 01:04:10,460
Yeah, for sure.

842
01:04:10,460 --> 01:04:15,980
And we'll link your show in the show notes as well for people to check out.

843
01:04:15,980 --> 01:04:23,660
This has been highly technical, certainly applicable in many cases, but maybe to pare

844
01:04:23,660 --> 01:04:26,020
it down to in like the most rudimentary sense.

845
01:04:26,020 --> 01:04:33,780
So if you were to roll into my gym, you had no training background, you obviously didn't

846
01:04:33,780 --> 01:04:37,740
have the knowledge that you have, the highly technical knowledge that you have.

847
01:04:37,740 --> 01:04:41,620
What would you want me to do as your trainer?

848
01:04:41,620 --> 01:04:43,340
What would you want me to ask you?

849
01:04:43,340 --> 01:04:46,600
How would you want that first session to go?

850
01:04:46,600 --> 01:04:49,960
What are just like the basic recommendations that you could have for maybe an aspiring

851
01:04:49,960 --> 01:04:53,300
fitness professional or a current personal trainer that's not working with individuals

852
01:04:53,300 --> 01:04:54,540
with SEI?

853
01:04:54,540 --> 01:05:01,360
I would start with a comprehensive or maybe less than comprehensive assessment of abilities

854
01:05:01,360 --> 01:05:06,500
within the body and be keen about language as a practitioner.

855
01:05:06,500 --> 01:05:11,420
Know that maybe not offensive language is the right word, but language that doesn't

856
01:05:11,420 --> 01:05:15,020
supplement that to motivation and excitement.

857
01:05:15,020 --> 01:05:20,540
When you take a keen focus on what somebody can't do, that creates immediate challenges

858
01:05:20,540 --> 01:05:24,660
of rapport building and trust with them, that that's where your focus is rather than the

859
01:05:24,660 --> 01:05:30,660
focus being on what they can do and building off of that to create more ability in their

860
01:05:30,660 --> 01:05:31,660
function.

861
01:05:31,660 --> 01:05:37,160
So when we look at that requisite Lee in real time, look at somebody's abilities.

862
01:05:37,160 --> 01:05:42,000
Also ask them what are their smart goals, specific, measurable, attainable, realistic

863
01:05:42,000 --> 01:05:48,780
and under what timeframes and then frame that up, frame that up also with your recommendations

864
01:05:48,780 --> 01:05:50,660
for them from your perspective.

865
01:05:50,660 --> 01:05:52,740
Look at their body very holistically.

866
01:05:52,740 --> 01:05:58,340
If somebody's in a chair, conduct a visual assessment of them when they come in and this

867
01:05:58,340 --> 01:05:59,340
can be done.

868
01:05:59,340 --> 01:06:00,900
Here's a couple of examples.

869
01:06:00,900 --> 01:06:01,900
How are that?

870
01:06:01,900 --> 01:06:03,980
What's their posture like?

871
01:06:03,980 --> 01:06:04,980
How are they sitting?

872
01:06:04,980 --> 01:06:06,460
Do they look comfortable?

873
01:06:06,460 --> 01:06:07,900
What's their body language?

874
01:06:07,900 --> 01:06:09,500
Are their arms crossed?

875
01:06:09,500 --> 01:06:15,220
And if they are, is it because they're fixed or is it because that's a position of a defense

876
01:06:15,220 --> 01:06:16,340
mechanism?

877
01:06:16,340 --> 01:06:20,820
Let's start looking at the psychological responses to this because we know that when we have

878
01:06:20,820 --> 01:06:24,580
somebody's attention and they're receptive, their arms are typically open or at their

879
01:06:24,580 --> 01:06:25,580
side.

880
01:06:25,580 --> 01:06:26,980
They're not closed off.

881
01:06:26,980 --> 01:06:31,180
So how are they presenting in terms of body language?

882
01:06:31,180 --> 01:06:35,780
Is the body language representative of that of a psychological emotional response or is

883
01:06:35,780 --> 01:06:40,460
it representative of that of a physiological response where maybe the body's under conformity?

884
01:06:40,460 --> 01:06:45,320
They're slouched one way, they're hunched over, they have bad posture.

885
01:06:45,320 --> 01:06:47,500
How are their feet sitting on their chair?

886
01:06:47,500 --> 01:06:49,100
Are their feet kicked off their chair?

887
01:06:49,100 --> 01:06:52,100
That would be indicative of tone or spasticity.

888
01:06:52,100 --> 01:06:55,900
Do they have plantar flexion at the ankles where the ankle is not sitting flat on the

889
01:06:55,900 --> 01:06:57,940
toe plate?

890
01:06:57,940 --> 01:07:03,020
How are their legs recessed back underneath them or farther forward on the toe plate?

891
01:07:03,020 --> 01:07:08,340
It might tell you about the length that they have in their hamstring and behind the knee.

892
01:07:08,340 --> 01:07:13,260
There is so many different visual cues that you can pick up on just from somebody in a

893
01:07:13,260 --> 01:07:16,580
chair that can tell you where to start.

894
01:07:16,580 --> 01:07:20,540
Somebody walks in on a walker, assess their gait.

895
01:07:20,540 --> 01:07:24,020
Are they loading too much through their shoulders?

896
01:07:24,020 --> 01:07:32,740
Are they properly postured where maybe the walker is just supplemental and not fundamental?

897
01:07:32,740 --> 01:07:37,520
And start to use your fitness mind and background from there.

898
01:07:37,520 --> 01:07:43,540
If you're already oriented around fitness, you know, posture, PDIC, you know, anatomics,

899
01:07:43,540 --> 01:07:50,860
you know, physiology, you know, biomechanics, apply those same things and then supplemental

900
01:07:50,860 --> 01:07:56,140
education for the neurological side of it can come in due time.

901
01:07:56,140 --> 01:08:01,180
Think about how you would want to be trained, how you would want to be rehabilitated.

902
01:08:01,180 --> 01:08:07,180
Put yourself positionally into the modalities and the exercises that you are the clients.

903
01:08:07,180 --> 01:08:08,820
Try to feel what they feel.

904
01:08:08,820 --> 01:08:10,900
Try to interpret what they interpret.

905
01:08:10,900 --> 01:08:15,340
Have somebody else be the third body that is applying that or the second body that's

906
01:08:15,340 --> 01:08:20,740
applying that input back into the sensory and proprioceptive input, the load bearing,

907
01:08:20,740 --> 01:08:23,460
resistance bearing input in a closed chain environment.

908
01:08:23,460 --> 01:08:28,860
Should you train them closed chain, focusing on functionality, or should you train open

909
01:08:28,860 --> 01:08:32,600
chain to focus on muscles?

910
01:08:32,600 --> 01:08:35,340
What is the body calling for?

911
01:08:35,340 --> 01:08:42,100
Use your logic, don't overthink it, but start with the visual cues first.

912
01:08:42,100 --> 01:08:45,180
Ask the deepening questions to gain the assessment.

913
01:08:45,180 --> 01:08:52,980
Gather the information around fundamental needs, wants, desires, goals, and work forward.

914
01:08:52,980 --> 01:08:56,300
What are the contraindications that someone should be aware of?

915
01:08:56,300 --> 01:08:59,420
Can a trainer do more harm than good?

916
01:08:59,420 --> 01:09:04,660
I would say contraindications to be wary of are definitely, and we have this as a prerequisite

917
01:09:04,660 --> 01:09:08,820
requirement here, is bone density affluency.

918
01:09:08,820 --> 01:09:13,580
Is somebody in an osteoporotic state where it really would be detrimental for you to

919
01:09:13,580 --> 01:09:18,020
load bear intensely with them or manipulate them in a particular way?

920
01:09:18,020 --> 01:09:20,720
Do they have dislocated hips?

921
01:09:20,720 --> 01:09:24,820
Where do they have heterotrophic ossification at what joints?

922
01:09:24,820 --> 01:09:29,240
Do they have a shortening in particular muscle groups that don't allow for full range that

923
01:09:29,240 --> 01:09:33,940
if you were just to crank them to full range, you're going to rip some sort of legament

924
01:09:33,940 --> 01:09:35,740
or muscle?

925
01:09:35,740 --> 01:09:38,740
Where does sensation stop?

926
01:09:38,740 --> 01:09:43,060
You can really be mindful of what type of pressures you're applying to the body to

927
01:09:43,060 --> 01:09:48,580
not make the body susceptible to pressure sores through rubbing and deterioration of

928
01:09:48,580 --> 01:09:50,480
skin.

929
01:09:50,480 --> 01:09:55,440
Is somebody a woman pregnant that would maybe differentiate of what types of pressures you

930
01:09:55,440 --> 01:09:59,000
put on the abdominal regions?

931
01:09:59,000 --> 01:10:04,260
Does somebody have setbacks with blood pressure because would they be more likely to pass

932
01:10:04,260 --> 01:10:05,420
out?

933
01:10:05,420 --> 01:10:07,900
Is somebody a diabetic?

934
01:10:07,900 --> 01:10:11,940
Do they need to have proper nutrition, which that would be the case for anybody by the

935
01:10:11,940 --> 01:10:17,860
way, your water intake and your food intake pre-workout to be able to be supplementally

936
01:10:17,860 --> 01:10:23,340
in a place where you are conducive towards high intensity unorthodox approaches towards

937
01:10:23,340 --> 01:10:25,620
working out.

938
01:10:25,620 --> 01:10:30,820
But I would just say use your logic if you were in a debilitated state and vastly hurt,

939
01:10:30,820 --> 01:10:33,860
how wouldn't you want to be moved and manipulated?

940
01:10:33,860 --> 01:10:37,700
But you got to be asking the appropriate questions because likely you're going to have to be a

941
01:10:37,700 --> 01:10:41,640
greater advocate for a client's safety needs than they are themselves.

942
01:10:41,640 --> 01:10:44,020
They don't really know what they don't know.

943
01:10:44,020 --> 01:10:48,460
And for a lot of them, they're going to entrust in the fact that the most important thing

944
01:10:48,460 --> 01:10:52,100
is going to be met and you're going to keep them safe because that's their greatest fear

945
01:10:52,100 --> 01:10:56,260
post injury and accident is to get re-injured, maybe not to that grade of a capacity, maybe

946
01:10:56,260 --> 01:11:00,900
they've ruled that out, but any sort of fear around any injury, they want to make sure

947
01:11:00,900 --> 01:11:05,620
the practitioners that they've lent their hand to is in a trustful and rapport building

948
01:11:05,620 --> 01:11:12,180
state where it's only an upward trajectory of health as opposed to a vast setback.

949
01:11:12,180 --> 01:11:17,020
What was the vision that you had for your life before your accident and what is it that

950
01:11:17,020 --> 01:11:20,120
you have now?

951
01:11:20,120 --> 01:11:27,700
I could say there's two barometers that I have that define my pre-birth or my previous

952
01:11:27,700 --> 01:11:30,660
life and now the rebirth.

953
01:11:30,660 --> 01:11:38,180
Previous life, selfish vision, take over a business that my father was involved in, go

954
01:11:38,180 --> 01:11:47,820
to school, play baseball, fulfill the self-fulfilling accolades, live the college life.

955
01:11:47,820 --> 01:11:52,900
I got injured at 17 a month and a half after graduation from high school.

956
01:11:52,900 --> 01:12:00,020
New version, new me, rebirth, vision for life is meaning and purpose around serving people.

957
01:12:00,020 --> 01:12:02,740
I have everything I need.

958
01:12:02,740 --> 01:12:07,180
Great family, great wife, beautiful daughter.

959
01:12:07,180 --> 01:12:14,100
I have a mission that I'm fulfilling, value and purpose in my life to make this world

960
01:12:14,100 --> 01:12:21,140
a better place and I've recognized the people around me matter more than I do myself because

961
01:12:21,140 --> 01:12:26,460
they're the ones that give me the value and purpose.

962
01:12:26,460 --> 01:12:32,220
My vision statement in the world is to see a world that isn't debilitated through the

963
01:12:32,220 --> 01:12:40,780
indifference of social customs to the wheelchair community living amongst the able-bodied community

964
01:12:40,780 --> 01:12:47,980
and that there's affordable access to safe healthcare that can allow people to recover.

965
01:12:47,980 --> 01:12:53,900
My mission is not just to identify that challenge but to be a part of the solution to solve

966
01:12:53,900 --> 01:12:54,900
it.

967
01:12:54,900 --> 01:13:00,780
How do you want your work to influence the way that your daughter looks at the world

968
01:13:00,780 --> 01:13:06,500
and the world that she grows up in?

969
01:13:06,500 --> 01:13:09,240
My daughter is a miracle in herself.

970
01:13:09,240 --> 01:13:13,320
My wife and I had four and a half years of infertility challenges.

971
01:13:13,320 --> 01:13:16,980
We incurred over 10 loss embryos.

972
01:13:16,980 --> 01:13:24,420
My wife stabbed herself with needles into her own flesh over 615 times to see this one

973
01:13:24,420 --> 01:13:33,180
being come to life and we received a blessing and I don't want that to be the guilty connotation

974
01:13:33,180 --> 01:13:38,180
as she grows older to understand what a blessing she is and what it took to have her but I

975
01:13:38,180 --> 01:13:44,300
want her to have awareness of focusing on the things she has rather than being so wrapped

976
01:13:44,300 --> 01:13:49,460
up in what she doesn't because in a world that is so divisive and in a world that can

977
01:13:49,460 --> 01:13:55,660
be very ugly sometimes, oftentimes it is the indifference that we face cognitively with

978
01:13:55,660 --> 01:14:00,460
the dissonance in our mind between our thoughts and our actions and much of that stems from

979
01:14:00,460 --> 01:14:06,740
a focus on kind of this idea of jealousy of looking around through social media and other

980
01:14:06,740 --> 01:14:12,000
social properties where we look at what others have and we either wish ill upon them or we

981
01:14:12,000 --> 01:14:16,980
wonder why they have that or why they're deserving of that and we start to look internally at

982
01:14:16,980 --> 01:14:22,180
what we don't have and we think that we've been cursed when really all we've been is

983
01:14:22,180 --> 01:14:23,620
blessed.

984
01:14:23,620 --> 01:14:28,580
Your greatest blessing is your next breath, your ability to live in the here and now,

985
01:14:28,580 --> 01:14:35,100
to seek forth the opportunity to exercise your passions, to execute your vision, to

986
01:14:35,100 --> 01:14:41,340
make your mission a purposeful reality so others can live in a better world and a better

987
01:14:41,340 --> 01:14:44,360
place that you've been a part of forming.

988
01:14:44,360 --> 01:14:49,400
So I hope she takes forth the values of diversity, equity, and inclusion to not see indifference

989
01:14:49,400 --> 01:14:53,460
when she looks at somebody else that maybe she doesn't know their story, that she runs

990
01:14:53,460 --> 01:15:01,700
to curiosity first before she does judgment, that she tries to provide an equitable place

991
01:15:01,700 --> 01:15:10,300
and it may not always be equal but equitable, a place where it's accommodating, where maybe

992
01:15:10,300 --> 01:15:15,460
if somebody needs a ladder to reach something, you don't just have a six foot ladder there

993
01:15:15,460 --> 01:15:19,560
for everybody to use but maybe you have a four foot and a 12 foot ladder because you're

994
01:15:19,560 --> 01:15:22,420
accommodating to people of different heights.

995
01:15:22,420 --> 01:15:31,400
So not only provide something but have accommodations that curtail towards people that also want

996
01:15:31,400 --> 01:15:36,180
to be involved and also want to be contributed to the same things that matter to you.

997
01:15:36,180 --> 01:15:40,700
I wanted to know that be passionate about your voice.

998
01:15:40,700 --> 01:15:44,580
You might think that you're one voice and what can one voice make in terms of a difference

999
01:15:44,580 --> 01:15:45,880
in this world?

1000
01:15:45,880 --> 01:15:48,740
What does one vote make in terms of a difference in this world?

1001
01:15:48,740 --> 01:15:52,500
Well, it's a very simple philosophy.

1002
01:15:52,500 --> 01:15:57,180
You went out, you were at a park and you picked up a stick, you would break it but if you

1003
01:15:57,180 --> 01:16:01,580
picked up 10 sticks, could you break them?

1004
01:16:01,580 --> 01:16:03,740
Build your collective.

1005
01:16:03,740 --> 01:16:06,360
You are the sum of the closest people to you.

1006
01:16:06,360 --> 01:16:08,620
Don't get wrapped up in belief systems.

1007
01:16:08,620 --> 01:16:11,060
The world is intended to divide.

1008
01:16:11,060 --> 01:16:13,800
We look at this person, we say they believe differently.

1009
01:16:13,800 --> 01:16:17,940
They chose red or they chose blue or they chose pro-life or not pro-life.

1010
01:16:17,940 --> 01:16:22,620
There's controversial topics, all of which from our standpoint, the life we're living,

1011
01:16:22,620 --> 01:16:25,980
the upbringing we were brought up in, they're right in our eyes.

1012
01:16:25,980 --> 01:16:29,020
But we were all intended to believe different.

1013
01:16:29,020 --> 01:16:33,100
But I wanted to focus rather on beliefs that somebody else has.

1014
01:16:33,100 --> 01:16:36,060
Look at their morals, values and ethics.

1015
01:16:36,060 --> 01:16:38,820
That will tell you who they are as a person.

1016
01:16:38,820 --> 01:16:44,000
And generally speaking, we all want to be good people.

1017
01:16:44,000 --> 01:16:46,500
We all don't want to kill.

1018
01:16:46,500 --> 01:16:49,900
We all want to heal and heal each other.

1019
01:16:49,900 --> 01:16:58,260
Yeah, well I would imagine your life in many ways is better because of your injury, not

1020
01:16:58,260 --> 01:17:00,740
to imply that for you.

1021
01:17:00,740 --> 01:17:03,940
I'll spare you the words, yes.

1022
01:17:03,940 --> 01:17:04,940
Yeah.

1023
01:17:04,940 --> 01:17:05,940
Completely better.

1024
01:17:05,940 --> 01:17:06,940
Yeah.

1025
01:17:06,940 --> 01:17:07,940
Yeah.

1026
01:17:07,940 --> 01:17:13,380
And I hope that message reaches a lot of people, maybe not even that are going through as traumatic

1027
01:17:13,380 --> 01:17:19,780
of an experience as an SCI, but just how something negative can be turned into such a positive.

1028
01:17:19,780 --> 01:17:25,100
I don't know how people can look at my accident and think it started negative.

1029
01:17:25,100 --> 01:17:32,660
I think people see an accident as rejection, but really it's redirection.

1030
01:17:32,660 --> 01:17:38,580
Like if I'm victimizing myself, maybe I look at my accident and I think, why did I get

1031
01:17:38,580 --> 01:17:41,100
it the worst I could have got it?

1032
01:17:41,100 --> 01:17:44,860
Well really I was given the blessing of continued life.

1033
01:17:44,860 --> 01:17:49,740
Maybe amid the circumstances of my accident, I was given the best outcome I could have

1034
01:17:49,740 --> 01:17:52,220
got.

1035
01:17:52,220 --> 01:17:55,540
You might look at me and say, wow, you've been dealt a really bad hand, but I look at

1036
01:17:55,540 --> 01:17:58,920
my hand and I say, I have a royal flush that I'm sitting with.

1037
01:17:58,920 --> 01:18:00,940
I don't know what you're seeing.

1038
01:18:00,940 --> 01:18:04,780
I have continued life, continued breath, continued purpose.

1039
01:18:04,780 --> 01:18:05,780
What more do I need?

1040
01:18:05,780 --> 01:18:09,480
My wife told me everything I needed to know on the altar.

1041
01:18:09,480 --> 01:18:14,940
During our vows, she said, I did not marry you on the account of whether or not you could

1042
01:18:14,940 --> 01:18:15,940
walk.

1043
01:18:15,940 --> 01:18:17,980
That did not determine the man you were.

1044
01:18:17,980 --> 01:18:24,060
What determined who you were was your commitment, your loyalty, your value orientation, your

1045
01:18:24,060 --> 01:18:30,140
confidence, your respect, your love, your healing, your presence.

1046
01:18:30,140 --> 01:18:33,600
None of that had to do with my legs.

1047
01:18:33,600 --> 01:18:39,040
If I could talk to the 17 year old version of me at time of my injury, I'd say, it's

1048
01:18:39,040 --> 01:18:42,940
going to be okay because you're going to have a community.

1049
01:18:42,940 --> 01:18:44,180
You're going to have friends.

1050
01:18:44,180 --> 01:18:47,860
You're going to have family and you're going to find the two things that we're all looking

1051
01:18:47,860 --> 01:18:51,360
for in life, love and acceptance.

1052
01:18:51,360 --> 01:18:56,420
And I found somebody that loves me and she didn't even know me pre-accident that she

1053
01:18:56,420 --> 01:18:59,260
grew to love this version of me.

1054
01:18:59,260 --> 01:19:04,020
I found acceptance there in and through her and in and through everybody like yourself

1055
01:19:04,020 --> 01:19:07,220
so I can live confidently in my skin.

1056
01:19:07,220 --> 01:19:15,340
Like I'm living the Holy grail and my accident was the one thing that was intended to happen

1057
01:19:15,340 --> 01:19:17,240
to me.

1058
01:19:17,240 --> 01:19:21,280
And I always think, why not me?

1059
01:19:21,280 --> 01:19:24,900
Not only am I built for this, but I'm going to recognize my blessings and not piss this

1060
01:19:24,900 --> 01:19:26,660
second life away.

1061
01:19:26,660 --> 01:19:28,260
It's too good to be true.

1062
01:19:28,260 --> 01:19:36,540
Yeah, Hal, I think more people should have you on their podcast, should share your message

1063
01:19:36,540 --> 01:19:37,660
with their audiences.

1064
01:19:37,660 --> 01:19:44,180
So I hope they take me up on that offer and I hope you are okay with me promoting you

1065
01:19:44,180 --> 01:19:45,180
in that way.

1066
01:19:45,180 --> 01:19:49,380
If people want to connect with you, whether it's you personally or through the perfect

1067
01:19:49,380 --> 01:19:54,540
step or maybe those two things aren't always mutually exclusive, what's the best way or

1068
01:19:54,540 --> 01:19:57,060
the best place for them to find you?

1069
01:19:57,060 --> 01:20:02,940
I'm never one for self-promotion, but if there is at all advocacy work involved with speaking

1070
01:20:02,940 --> 01:20:07,260
for a broader community that maybe is outside of this office right now and believes they

1071
01:20:07,260 --> 01:20:12,060
don't have a voice, that their opinion doesn't matter, that their story shouldn't be told

1072
01:20:12,060 --> 01:20:17,460
because they believe it's a story of despair or pain or weakness, those are the same people

1073
01:20:17,460 --> 01:20:20,780
I look at and say, how are you living through what you're living through?

1074
01:20:20,780 --> 01:20:26,580
You're symbolic of strength and hope and a life worth living.

1075
01:20:26,580 --> 01:20:30,860
So if that's what you believe I can provide to you in the form of advocacy work, you can

1076
01:20:30,860 --> 01:20:36,980
find me on Instagram, Hal Hargrave, Facebook, LinkedIn, send me an email, halhargrave at

1077
01:20:36,980 --> 01:20:38,800
theperfectstep.com.

1078
01:20:38,800 --> 01:20:44,980
You can check out our website, theperfectstep.com, press contact us or even just reach out directly

1079
01:20:44,980 --> 01:20:45,980
to Brendan.

1080
01:20:45,980 --> 01:20:50,860
You are more than welcome to share the information if it's going to be a part of making the difference

1081
01:20:50,860 --> 01:20:52,180
that I want to see in this world.

1082
01:20:52,180 --> 01:20:58,580
And that is a full reform at a foundational level of what we start to believe diversity,

1083
01:20:58,580 --> 01:21:04,780
equity and inclusion is and how we reform healthcare to give reimbursable healthcare

1084
01:21:04,780 --> 01:21:09,460
to the things that our clients really want for themselves.

1085
01:21:09,460 --> 01:21:15,540
I'll include those pages, those links in the show notes for people to easily find.

1086
01:21:15,540 --> 01:21:18,420
Hal, thanks again.

1087
01:21:18,420 --> 01:21:21,860
This was an incredible conversation and I can't wait to share it.

1088
01:21:21,860 --> 01:21:26,700
You are an unbelievable host and I really felt like you brought out the vulnerable in

1089
01:21:26,700 --> 01:21:30,220
me and only a good and seasoned vet could do that.

1090
01:21:30,220 --> 01:21:32,100
So that's all for you, Brendan.

1091
01:21:32,100 --> 01:21:39,340
I'm more than happy and honored to be a part of what we talked about today.

1092
01:21:39,340 --> 01:21:41,640
Thank you for listening to the Adaptex podcast.

1093
01:21:41,640 --> 01:21:45,540
Our effort to amplify the ideas of our guests and create more inclusive and accessible industries

1094
01:21:45,540 --> 01:21:48,620
is futile unless these episodes reach a larger audience.

1095
01:21:48,620 --> 01:21:52,500
If you enjoyed our discussion today, please leave us a rating or review on whichever platform

1096
01:21:52,500 --> 01:21:53,500
you use.

1097
01:21:53,500 --> 01:21:56,520
And if you would like to learn more about Adaptex, the course that we teach to help

1098
01:21:56,520 --> 01:22:00,340
them fitness professionals in the projects that our organization is working on, you can

1099
01:22:00,340 --> 01:22:04,740
subscribe to our newsletter through our website www.adaptex.org.

1100
01:22:04,740 --> 01:22:27,180
Until next Monday.