Integrating Squegg PRO into Therapy Practices: A Guide for Clinicians

Squegg PRO serves as a comprehensive digital hub for clinicians to manage upper extremity therapy patients. The application allows healthcare providers to create patient profiles, assess grip and pinch strength of the patients, and create individualized home exercise programs (HEP). The user can access these programs via Squegg app supporting seamless tracking of patient progress, facilitating both in-clinic and remote therapeutic interventions. This dual approach is particularly advantageous for managing ongoing care and enhancing patient compliance.

Squegg PRO also offers a dashboard for clinicians to manage multiple patients efficiently. It centralizes patient data, offering options for comprehensive tracking, documentation, and reporting. Whether used in a clinical setting or remotely, Squegg PRO enables clinicians to maintain a high standard of care, ensuring continuity and accountability throughout the rehabilitation process.

Remote Therapeutic Monitoring (RTM)

Squegg PRO is ideal for Remote Therapeutic Monitoring, enabling clinicians to monitor patient progress and adjust therapy remotely. By using the app to track patient performance remotely, clinicians can provide continuous care, ensuring that patients remain on track with their rehabilitation even when they are not attending in-person sessions.

RTM also provides financial benefits, as clinicians can receive reimbursements for remotely monitoring their patients. The app simplifies the reporting and billing processes, ensuring that clinicians are compensated for the additional care they provide.

Implementation of Squegg PRO in Clinical Practice

1. Setting Up Squegg PRO App

Before you can start using Squegg PRO app with patients, you need to:

• Download the App: Install Squegg PRO app on your smartphone or tablet.
• Connect to the Squegg Device: Pair Squegg device with the app via Bluetooth. This allows you to monitor patient data in real time as they perform grip and pinch exercises.
• Create Clinician and Patient Profiles: Within the app, you can create profiles for the therapists and patients.

2. Initial Assessment and Baseline Measurement

When starting therapy for a new patient, after creating the patient profile, the first step is to assess their grip/pinch strength and set a baseline. This can be done by:

• Grip and Pinch Strength Assessment: Use Squegg PRO to measure the patient's grip and pinch strength. The app will record these values, providing an initial benchmark for comparison over time.
• Documentation: The app will store all these assessments securely, and you can generate reports for documentation purposes. This data is crucial for effective treatment planning, as it facilitates accurate tracking and optimization of patient care.

3. Designing Individualized Home Exercise Programs (HEPs)

Once the baseline has been established, you can design a tailored Home Exercise Program (HEP) for your patient:

• Customized Exercises: Use Squegg PRO app to select exercises that target the patient’s specific needs. The app includes activities to train grip strength, endurance, speed, and pinch strength.
• Assign Games and Activities: The app includes engaging, gamified exercises that motivate patients to perform their exercises consistently. Choose games that are suitable for the patient’s therapy goals and adjust the difficulty as needed.
• Adjusting Parameters: Based on the patient’s current ability, you can adjust the resistance, number of repetitions, and frequency of exercises. For instance, a patient recovering from hand surgery may start with low resistance exercises, gradually increasing as they regain strength.

(Customizing these parameters can ensure that the exercises are both challenging and optimum for the patient to perform.)

4. Tracking Patient Progress

One of the key benefits of Squegg PRO is its ability to track patient progress over time:

• Real-Time Feedback: As patients perform  their exercises, Squegg PRO records data, such as grip strength, duration, and compliance. The app provides real-time feedback to the patient as well as the clinicians.
• Remote Monitoring: Patients can complete their HEPs at home on Squegg app while you monitor their progress remotely on Squegg PRO app. This is particularly useful for patients who cannot attend in-clinic sessions regularly.
• Progress Reports: The app automatically generates detailed progress reports, which you can use to review the patient’s improvement over time. These reports are essential for documenting patient progress, justifying continued therapy, and communicating with insurance companies.

5. Adjusting Therapy Programs as Needed

As the patient progresses, it is essential to adjust their therapy program to match their evolving capabilities:

• Modifying Exercises: Based on the data collected by Squegg PRO, you can adjust the exercises in the HEP. If the patient’s strength is improving, you may increase the resistance or frequency of exercises. Conversely, if the patient is struggling, you can lower the intensity to prevent overexertion.
• Tracking Long-Term Progress: Over time, you can compare the patient's current performance to their baseline assessment. This allows you to objectively evaluate their improvement and make data-driven decisions about the next steps in their therapy.

6. Generating Reports for Documentation and Insurance

Squegg PRO simplifies the documentation process by automatically generating reports that include:

• Compliance and Engagement: Data on how consistently the patient has followed their HEP, which is essential for demonstrating adherence to therapy.
• Insurance Documentation: The reports generated by the app can be used to justify continued treatment and secure insurance reimbursement. Squegg PRO supports billing codes for Remote Therapeutic Monitoring (RTM), allowing clinicians to receive up to $175 per patient, per episode in reimbursements.

Reference:

1. Roberts, H. C., Denison, H. J., Martin, H. J.,  Patel, H. P., Syddall, H., Cooper, C., & Sayer., A. A. (2011). A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach. Age Ageing, 40, 423–429 (2011).

2. Mathiowetz, V., Kashman, N., Volland, G., Weber, K., Dowe, M., & Rogers, S. (1985). Grip and pinch strength: normative data for adults. Archives of Physical Medicine and Rehabilitation, 66(2): 69–74.

3. Bae, J. H.,  Kang, S. H., Seo, K. M., Kim, D. K., Shin, H. I., & Shin, H. E. (2015). Relationship Between Grip and Pinch Strength and Activities of Daily Living in Stroke Patients. Annals of Rehabilitation Medicine, 39(5), 752.

4. Nilsen, T., Hermann M, Eriksen C. S., Dagfinrud, H., Mowinckel, P., Kjeken, I. (2012). Grip force and pinch grip in an adult population: reference values and factors associated with grip force. Scandinavian Journal of Occupational Therapy, 19(3): 288–296.