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January/February 2003


The Inside Track



Lew Nasher, President/CEO

NeuroCom International, Clackamas, Ore, develops computerized systems for the assessment and rehabilitation of patients with balance and mobility problems. Rehab Management recently spoke with Lew Nasher, president and CEO, about his company and the rehab industry in general.

Q: What are your thoughts on the current state of the rehabilitation industry?

A: Rehab is clearly in transition right now. For many years, this industry had been viewed as an art. Each therapist treated each patient in a unique way based on their impression of the patient’s needs. Because of that, there weren’t any good objective outcomes showing how rehab actually makes a difference. Also, due to the enormous amount of cost-cutting in the last 5 years, the industry has become extremely vulnerable. Physical therapy in particular is in catch-up mode right now.

Q: How does your company fit in?

A: We manufacture high-tech equipment that objectively assesses patients with mobility problems. We also make equipment that allows therapists to focus on what we call an evidence-based approach to therapy, which is part of a growing trend in the industry right now. The main product we create, and which we pioneered, is our EquiTest® system. This is a machine that we use to make a differential impairment assessment on a patient. In the industry, it is known as computerized dynamic posturography, and it was actually developed with support from NASA to evaluate the effects of space flight on vestibular function and balance control in astronauts. We have now expanded it to work in our industry, as we use it to study the impact of intentional demands on balance.We use it to assist clinicians in assessing and treating patients with balance and mobility problems. Our balance evaluation and rehabilitation systems are used in a wide variety of disciplines, such as otolaryngology, neurology, orthopedic rehab, sports medicine, physical therapy, and geriatrics.

Q: NeuroCom was founded in 1984. What are some of the changes you have seen in the rehab industry since that time?

A: For one thing, in the early days of rehab, the focus was to just name the disease and not necessarily treat the patient. If a disease was not diagnosed, then the patient was often passed on to physical therapy. But now we have seen a move to where conditions are diagnosed and treatment happens with the same therapist. And it has become a rapidly growing field in general. For example, for a balance disorder like dizziness, our figures show that 23% to 30% of adults have experienced at least one episode in their life, with 3.5% experiencing chronic recurrent episodes for more than 1 year by age 65. That is obviously a huge number, and it has grown tremendously.

Q: What do you see as the biggest trend in the field right now?

A:There is an increase in an evidence-based, systematic approach to treating people with balance disorders. We are seeing a growth in our competition right now. In addition, there is an increasing need for standardized protocols that are backed by strong scientific and clinical evidence.

—Ben Van Houten

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