Mobility: The New Vital Sign….Dr. Daniel Kraft, Tech Nation Health Chief Correspondent
The ability to walk, climb stairs, get in and out of chairs is defining in life. It affects where you can go and how and what choices you have on a moment to moment basis. In fact, Technation Health chief correspondent, doctor Daniel Craft, says mobility is the new vital sign. Daniel, welcome back. Great to see you.
Dr. Daniel Kraft:It's great to be back.
Dr. Moira Gunn:Now you said something, when we were talking earlier about mobility being the new vital sign. You mean, people can actually measure what we're doing, and it becomes a part of our health profile. Is that what you're talking about?
Dr. Daniel Kraft:Yeah. I mean, mobility is really key to all elements of your health. How much you get around, your cardiovascular fitness, your ability to interact socially, and, you know, it's been a little underappreciated. I think, you know, you tell me. I think you actually had a a knee surgery a year ago.
Dr. Daniel Kraft:How did mobility affect your life?
Dr. Moira Gunn:Well, that's, you're talking to somebody who's a major fan. First of all, for all those people out there with knee replacements, I didn't have a full knee replacement. My hat is off to you. That is a huge, huge thing, but I was able to have a a partial knee replacement. And this is sort of like putting in a knuckle in one small part of my knee.
Dr. Moira Gunn:And, boy oh, boy, it's been a year. It's been a year. And, not only do I not have any pain, not only do I you you know, I'm moving around like I always did. I managed to lose 10 pounds without trying. And it's like, what that means to me is that the weight kinda when you can't move, the weight kinda creeps up on you because you're not moving the way you were, and you avoid moving because it hurts.
Dr. Moira Gunn:And then when you actually get some assistance, in my case, it was it was surgery, and it was the right surgery at the right time. And, I'm a I'm a major fan, and, what a what a big difference. You know, if without it, I could see why people sort of we say in the old days, anything that happened to your ability to move really just cut your life shorter and shorter and shorter, it seems to me.
Dr. Daniel Kraft:Yeah. It's a huge, you know, mobility is, or lack thereof is a big comorbidity. About twelve percent of Americans have just difficulty walking up and climbing stairs. And so I think what's interesting now, we talk about mobility as a new vital sign, is that, you know, that can sort of be quantified. Right?
Dr. Daniel Kraft:You can obviously tell with your Fitbit or your Apple Watch or your Oura ring or, you know, a simple pedometer, how much you're getting around is a basic measure. But now these sort of low cost consumer wearables can also tell you if your gait's a bit off. Maybe that one hip is a little stronger or weaker than the other, and maybe maybe it is time to go take a look at a a new knee or new hip if you're moving in the wrong direction or maybe to get a new orthotic and help your feet. I mean, my little mobility issue, boy, three or four years ago, I ended up with some plantar fasciitis, that sort of pain in the heel.
Dr. Moira Gunn:Oh, yeah.
Dr. Daniel Kraft:And There's not that much to do with stretching and the right kind of shoes, but, yeah, that really affects you and your ability to exercise and can affect mental health beyond it. We're now in this as we talked about on on prior episodes, we're in this digital age. And now what's interesting, your smartphone with the camera, you know, there's a few apps where you can literally put it up against the wall, stretch your arms, stand on one foot, stand on another, hop. It'll start to give you a bit of a mobility score and sort of see where you are. It might be to recommend some physical therapy or stretching or recognize folks who are likely to have a fall.
Dr. Daniel Kraft:We know that folks who are particularly in their older years, a fall can be literally deadly. The folks who get a a particularly broken hip, have a pretty low survivorship over over years and months. And so I think it's an extending age to number one, be able to measure it just with a silver wearable or a camera and then to guide folks to better musculoskeletal health. And we have some competing interest or we've talked about GLP one inhibitors and weight loss. A lot of those end up causing some sarcopenia, some sort of muscle wasting, and that can affect your mobility and especially as as you get older combined with things like your your bone strength.
Dr. Moira Gunn:Actually, anything that's measurable about you could be a vital sign. So you start you're starting to, you're starting to to persuade me here.
Dr. Daniel Kraft:Yeah. It's that we've you know, we're in the era of quantified self and quantified health, and our sort of low cost consumer devices and environments constructed measure them. And it's not about just measuring something, but what's actual information? What's something it could, keep you from ever knee needing that partial knee replacement or, hip replacement? Or what could measure someone's ability to get around in their early years and what can they do proactively when they're in their twenties, thirties, forties, fifties, sixties so that then when they're 90, they can get out of a chair by themselves.
Dr. Daniel Kraft:So I think it's a really interesting realm to start connecting those dots. At the same time, when people do have mobility issues, of course, we've seen the sort of standard walking cane, but even those are becoming sort of digitally enabled. There's one called the CanGo, which has a smartphone in it. It can track your steps, and if you've had a fall, I can call for help. And so it'd be a sort of a digital companion in your walking stick.
Dr. Daniel Kraft:There were in the ear early eras of exoskeletons. So someone who might have, weak leg from a stroke or from extreme age or other elements is gonna soon be able to strap on a little low cost, very lightweight exoskeleton that will give them extra oomph to their steps. I actually got to try on a pair of full exoskeletons that were made for folks who have full, like, paralysis. But there are some that are just enabling folks to run farther, stretch with the military world, of course, and carry more weight or in workplaces. But it's gonna really start to help, improve people's abilities, who have lost some of them.
Dr. Moira Gunn:I think what's also important, I know in my case, this had to do with a car accident, you know, decades ago, and, it had to do with how we were able to treat that particular injury then. We would never treat it that way now, but we are the, what we'd say, the inheritors. We're we actually have to understand that over time, even though we may have the best technology taking care of us when there is some kind of an accident or an incident, that's actually what we have to live with for the rest of our lives, and there may have to be an an intervention later on before you get to just the the vagaries of old age.
Dr. Daniel Kraft:Yeah. %. Now we're in the era of stem cell based regenerative medicine. There are several groups, including some ARPA h funded projects where instead of needing that knee replacement, you'll get an injection of stem or progenitor cells that turn back into chondrocytes and cartilage. That's sort of a bit of the holy grail here.
Dr. Daniel Kraft:But we're also gonna blend that with the world of, you know, AI and robotics. My friend Dean Kamen is well known for, as a medical device inventor, but invented the Segway. That Segway, that some of you have ridden around on the two wheels of balances really was the next generation of what was called the iBot. It's a wheelchair that enables folks who are in wheelchairs to be able to stand up, essentially, in the wheelchair and go over steps and go across grass. And so that's another mobility enabled tool.
Dr. Daniel Kraft:And then, other folks like, Hugh Herr, who's a professor at MIT who lost both his lower legs, from a climbing accident, has pioneered the world of sort of bionic limbs and this idea of, you know, neural interfaces so that these bionic limbs or prosthetics are now sort of connected to your brain. So you can sort of feel your movement and upskill that component. So it's a pretty exciting time to sort of see the entire spectrum. First, to sort of hopefully optimize your vitality and your mobility to find problems early before you might have a fall or need a a joint replacement or intervention. And then for folks with severe disabilities to start to enable them and some cases even super enable it.
Dr. Moira Gunn:Well, so many of us are used to we go to the doctor, say, every year. I've been bad. But I know you, Daniel. You say, god. You better get yourself down there.
Dr. Moira Gunn:I will. It's like you go in, and the first thing they do, they it seems like they take, you know, couple of pints of blood out of you, and they're like, okay. We wanna see everything we could read. At those times, no one ever checks out my balance. Nobody ever checks out really my my mobility and and, you know, how everything may be moving.
Dr. Moira Gunn:It seems to me they should.
Dr. Daniel Kraft:They should, and they can start to prescribe you mobility interventions. It could be, you know, an app for stretching or for doing sorts of exercises. Now it can blend with the world of augmented and virtual reality. These headsets are now $200, like the the ones from Meta or or from others where you put the headset on. And I I I play off in a game called supernatural where you're moving and you're hitting bats with the ball, balls with the bat, or doing boxing.
Dr. Daniel Kraft:You can now do that with other folks in social means. That can improve your mobility, particularly if you stretch after these interventions. Or the physical therapy. Right? Often folks go home from a, like, a knee surgery like yours.
Dr. Daniel Kraft:They're not necessarily walking enough or soldier soles, shoulder injury or or repair. And now you can put on the VR headset and kinda gamify those movements and those exercises. So we'll get you back up to full strength and mobility and, and give you a healthier, happier life.
Dr. Moira Gunn:I don't know about you, but if it's a game, I kinda forget that I'm doing what I'm doing and I just do it. You know? It's like, oh, that's fine. That's fine. If you can do that, you're actually more likely to do the exercises.
Dr. Daniel Kraft:Well, that's the whole one of the holy grails. The hardest thing across health and medicine is often behavior change. We know we're supposed to walk a bit more, eat a little bit less, have more social connection, maybe do our mindfulness. But it's really hard to get people to to often engage in gamification, whether it's badges or points or just making it a fun actual game in a VR headset can really get folks, much more on track both for prevention diagnostics and therapy and is gonna be part of this new sort of super convergent world of of of health and medicine.
Dr. Moira Gunn:No. Earlier you were referring to the ability for our brain to control one or another of these great inventions you've been talking about. Is that really where we're going with this? Not having to turn this on and move these things? We literally can do it with our brain.
Dr. Daniel Kraft:Well, the world of brain computer interfaces or BCI is really accelerating. Right? We've had, for the last decade or so, the ability for research teams to put a small chip on the cortex of the brain for folks who are often quadriplegic and enable them just by thinking to control a cursor or now control a three-dimensional robotic limb, for example. And that's, you know, still in research phases, but those are getting more and more capable to the point where they're adding in what's called somatosensation so that you're not only maybe thinking as a quadriplegic and you can control that robotic limb, but you can feel and, the touch, the temperature, body position. So the the the neuroengineering combining so that someone who's got a severe disability like quadriplegia can literally interact and feel their environment.
Dr. Daniel Kraft:So that's a very exciting component that several folks are working on. And there are new companies, one's called Science Corporation founded by Max Hodak that is is trying to build sort of biohybrid neural interfaces. The problem with a lot of these sort of chips in the brain is it destroys some of your neurons, a little tiny spikes that go into the brain or even the neural like element puts these little filaments that are, into the brain of the patient. Now there's this idea of actually having cells in their, axons grow from the surface into the brain and start to interface. So that's in the early research stages and moving to clinical trials and might be this brave new world of transhumanism where we'll start to hook our brains up to, neural connections.
Dr. Daniel Kraft:And that will, again, start to enable the disabled, that start to maybe even super enable us, those of us who have normal brains, but can sort of augment them with new connections to the world and to our bodies.
Dr. Moira Gunn:Well, think about all the people with diabetes who have neuropathies where they can't feel their extremities, portions of their extremities, and even more difficult, they can't feel heat. And so extreme heat, which is often what we dangerously encounter, for instance, when we're cooking, and extreme cold causing even more damage.
Dr. Daniel Kraft:Right. There are folks trying to sort of rewire the the neural system so that you can appreciate those. There are folks in the digital health space that are making special special socks that can pick up hot spots or injuries early. That's a huge area of of challenge for folks who have severe diabetes, and goes back to this issue of mobility. Many of the folk those folks often have peripheral vascular disease and some need amputations as well.
Dr. Daniel Kraft:So I think there's a brave new world of, you know, understanding mobility, optimizing it, and for those folks who have lost it, giving them back that capability, which is so intrinsic to our our our human nature.
Dr. Moira Gunn:Well, Daniel, thanks so much for coming in. Look forward to seeing you soon.
Dr. Daniel Kraft:Thanks, Mara. Keep on moving.
Dr. Moira Gunn:TechNation Health chief correspondent, doctor Daniel Craft, is the founder and chair of NextMed Health on the web at nextmed.health and digital.health. More information about Daniel at danielcraftmd.net.
