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“The Clinical Advantage”™

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As research continues to demonstrate the potential long term impact of concussionin sports, the importance of objective assessment in the management of concussionhas become vital.

Biodex Balance Assessment for Concussion Management adds the objectiveneurophysical component that gives clinicians the ability to quantify the elementsof balance before and after an injury occurs. Using the Clinical Test of SensoryIntegration of Balance (CTSIB), Biodex Balance Assessment can independently testall three sensory feedback systems (visual, vestibular and somatosensory).

The objective data provided by the Biodex Balance Assessment tool provides aperformance baseline against which post-injury performance can be compared. Inaddition, a healthy population of student-athletes is stored on the system forgeneral normative data comparison.

Detailed summary and progress reports track recovery and provide the medicalteam with quantitative data to help with the return-to-play decision.

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Baseline tests are given to athletespreseason to establish an individualathlete’s normal, pre-injury performance.

Today, the proper management ofconcussion should include baseline BalanceAssessment, Cognitive Assessment andGraded Symptoms Checklist.

The NCAA® and NATA® have identifiedthese as the three essential assessmentpillars.

When combined, these preseason baselinetests can provide a comparison point forcognitive function and objectivelyquantified balance for athletes. In the caseof a suspected concussion, it is thesebaseline tests which post-injury assessmentsare compared, providing the objective datanecessary to track recovery.

Balance Assessment

CognitiveAssessment

Best Practice

GradedSymptomsChecklist

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Data from objective measures of postural stability is a critical component in determiningseverity of injury and post-injury recovery.

Both the Biodex Balance System SD and portable BioSway provide posturalstability/balance testing with objective documentation including detailed baseline andpost-injury summary reports and progress reports with comparison to normative data.

NEW normative databases are available targeting athletic population for a leadingedge with balance assessment for concussion management.

Updated Patient Data Collection Utility Software provides an easy way to export patientdata as a .csv file for statistical analysis or Excel to create your own normative data.

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Research shows that athletes often demonstrate decreasedstability post-concussion. The postural stability deficit can best be explained by a sensory interaction problem thatprevents concussed athletes from accurately using andexchanging sensory information from the visual, vestibular,and somatosensory systems.6

Large negative effects in postural sway are often identified at both immediate and follow-up assessment points,demonstrating the need for assessment of postural control as part of a concussion protocol. Difficulty in postural swaycontrol may persist even after signs and symptoms ofconcussion reside.7

Today, postural stability testing is an accepted objectivemeasure in the evaluation of athletes with acute cerebralconcussion.

In fact, research has shown that balance assessment, incombination with cognitive testing and a graded symptomschecklist, increases overall sensitivity to greater than 90%.8

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NOTE: The position of the arrows in the enlarged view in relation to normative mean between the Baseline and Post-injury Assessment.

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Scott Stein, Athletic Director Sun Valley High School, NC

Biodex Balance Assessment is conducted using either the versatileBalance System™ SD or portable BioSway™. The Biodex BalanceSystem SD is a sophisticated measuring and training device for staticand dynamic balance testing and training. The BioSway is a portablebalance device limited with a static-only platform.

The CTSIB can be performed on either Biodex balance device,designed to systematically test the sensory selection process bycompromising available somatosensory, visual and vestibular senseswhile measuring an athlete’s ability to minimize postural sway.

The test provides a generalized assessment of how well an athlete canintegrate various senses with respect to balance, and compensatewhen one or more of those senses are compromised.

The Sway Index is an objective quantification of postural sway and ismeasured during the CTSIB. The test provides a generalizedassessment of how well an athlete can integrate various senses withrespect to balance, and compensate when one or more of those sensesare compromised. A higher Sway Index indicates a reduction in theathlete’s ability to remain steady during the test.

In addition to performing the CTSIB test, the NEW version of theBalance System SD and BioSway software now includes the option ofconducting a modified version of a Balance Error Scoring System(BESS) test of postural stability, popular for concussion management.Both systems now feature the ability to create custom sensoryintegration balance testing which allows for modification of existingprotocols or the creation of entirely new ones with both the CTSIBand BESS tests.9

The Clinical Test of Sensory Integration of Balance (CTSIB) is theaccepted standardized assessment that identifies and tracksdisturbances in balance and the three associated sensory systems.

Combined with today’s technological advances, the CTSIB providesthe sports medicine community with a more accurate and objectiveassessment tool for evaluating postural stability.

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The Biodex mCTSIB quantifies postural sway under thesefour sensory conditions:

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����������������������.F�HIDCI�B<AI9<GDEHGG�The Balance System SD not onlyserves your concussion managementneeds, but offers multiplerehabilitation and athletic trainingprotocols that can be used across abroad scope of athletic populationfor general orthopedic andneuromuscular rehabilitation andathletic conditioning.

The Biodex Balance Assessment for Concussion Management with Balance System SD can pay foritself in as little as 13 weeks.

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Biodex Rehabilitation Equipment is commonly used in rehabilitation services based on the following ICD-9 codes:

The following CPT codes can be applied. Reimbursement amounts vary among plans and states.97110 Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercise to develop strength, endurance, range of motion and flexibility

97112 Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities.

97530 Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes

97750 Physical performance test or measurement (eg. Musculoskeletal, functional capacity) with written report, each 15 minutesNOTE: Most insurance plans cover concussion assessment evaluation and rehabilitation. Estimates may vary from region to region.

780.40 Dizziness 781.20 Imbalance 850.00 Concussion without LOC850.10 Concussion with brief LOC850.11 Concussion with LOC<30 minutes

850.12 Concussion LOC 31 to 59 minutes850.50 Concussion with unspecified duration of LOC850.90 Concussion unspecified (NOS)310.20 Post-concussion Syndrome (PCS)

The Biodex Balance Assessment Program for Concussion Management is the most widely usedobjective Neurophysical Testing tool on the market today. The Biodex Concussion PRO Package

features the versatile Biodex Balance System SD. The objective data generated by the BalanceSystem SD provides a performance baseline against which post-injury performance can be

compared. In addition, a healthy population of student athletes is stored in the Balance System SDfor general normative data comparison.

This is an excellent tool in the growing field of Concussion Management, and a great way to differentiate your practice.

FACILITY LETTERHEAD

MARKETING SUPPORT

Sample Letter to Athlete Parents

Remove the guesswork… enroll your athlete in a

Biodex Concussion Management Program

Dear Of great concern to a parent when a child suffers a concussion is: Will there be lasting

effects? And, when is the child ready to resume sports and other activities?

[Facility Name Here] can help answer those questions. Our facility now offers the Biodex

Concussion Management Program which is used by leading hospitals, rehabilitation

centers and top Professional and University sports teams as a concussion management

tool. [Facility Name Here] would like an opportunity to discuss the program and provide

your child with a simple baseline test of balance and cognitive assessment.

The test takes only minutes but will provide valuable information in the event your child

sustains a concussion. If your child has had a concussion, we can work with you and your

child’s doctor to manage the recovery process. Almost one-third of nearly 3 million

concussion cases diagnosed annually occur with children under the age of 14. It is also

the most common sports-related brain injury among 15 to 24 year olds. It is important to understand who is susceptible. School-aged children engaged in contact

sports are in a high-risk group, for not only suffering one concussion, but also a

dangerous reoccurrence. Each concussion is different, so too is your child’s recovery

process. Having objective baseline and data-driven support is essential for those difficult

return-to-play decisions. We look forward to discussing the benefits of the program with you. Please call for a

time to set up an evaluation. Sincerely,

Concussion Management Program

Marketing Support

Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New York, 11967-4704, Tel: 800-224-6339 (Int’l 631-924-9000), Fax: 631-924-9338, Email: info@biodex.com, www.biodex.com

BIODEX

FN: 12-366 1/13

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Biodex Balance Assessment Program for Concussion Managementwith Balance System SD

SAMPLE FINANCIAL MODELAverage # of new clients per week

2

Number of weeks per year

x 52Total number of new clients per year

= 104 (A)Average Treatment Reimbursement per clientInitial Concussion Assessment Evaluation & Patient Education

$86

Concussion Rehab visits ($76 x 4 sessions)+ $304

Concussion Assessment Re-evaluation & Patient Education+ $86

Total Average Reimbursement per client= $476 (B)

Average Annual Reimbursement (A x B)

$49,504 (C)

Average cost of Biodex Balance System SD with Concussion Software$12,750 (D)

Average Reimbursement per week (C/52)

$952 (E)Cost of unitAverage weekly reimbursement = 13.4 weeks

ROI expected (D / E)

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Available Treatments:

Balance/Proprioception Program

Lumbar Stabilization Program

Sports Injury Assessments

Sports Enhancement

Post Surgical Rehabilitation

Athletic Conditioning

Fall Risk Assessment

Orthopedic Injuries:

Shoulder Pain

Knee Pain

Ankle Pain

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Available Treatments:

Balance/Proprioception Program

Lumbar Stabilization Program

Sports Injury Assessments

Sports Enhancement

Post Surgical Rehabilitation

Athletic Conditioning

Fall Risk Assessment

Orthopedic Injuries:

Shoulder Pain

Knee Pain

Ankle Pain

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Available Treatments:

Balance / Proprioception ProgramLumber Stabilization Program

Sports Injury AssessmentsSports Enhancement

Post Surgical RehabilitationAthletic ConditioningFall Risk Assessment

Orthopedic Injuries:

Shoulder PainKnee PainAnkle Pain