Post-op recovery & movement monitoring

80% of orthopaedic conditions
respond to structured movement.
Surgery is right for 20%.

Knowing which is which requires a different kind of evaluation — one that starts with movement, not imaging. KineticFirst is the structured movement-first pathway: AI-guided home exercise, remote physician oversight, and the data trail that tells you whether surgery is actually next.

For patients recovering from surgery, managing chronic orthopaedic conditions, or trying to avoid an operation they may not need.

For clinicians — RTM billing →

accuracy: gait speed predicts hospitalization

RTM reimbursement per patient per year

avg HSA/FSA unlocked via LMN per year

caregiver turnover — cut to 15% with co-op ownership

Movement-first in practice

What gets better with movement.
What still needs surgery.

The distinction is not ideological — it is clinical. These are the evidence-based categories.

Responds well to structured movement

Hip and knee osteoarthritis (mild to moderate)

Strength training + range-of-motion work reduces pain scores by 30–50% in RCTs. Delay surgery until muscle atrophy and significant joint space loss.

Chronic low back pain (non-radicular)

The ACP puts structured exercise above NSAIDs as first-line. Lumbar fusion rarely improves outcomes versus a supervised rehab program for non-specific LBP.

Rotator cuff tendinopathy (partial tears)

Eccentric strengthening produces outcomes equivalent to surgical repair for partial-thickness tears at 12-month follow-up (Kukkonen et al., 2015).

Post-surgical recovery (after any joint procedure)

The first 6–24 months after surgery are where home-based movement monitoring is most predictive. Gait speed at 3 months post-TKA predicts 12-month outcomes.

When surgery is the right answer

Full-thickness rotator cuff tears with functional loss

When overhead function is lost and conservative treatment at 3 months shows no improvement — surgical repair with early PT gives better long-term outcomes.

Severe joint space narrowing with failed 6-month rehab

When bone-on-bone contact produces constant pain and movement therapy no longer provides functional improvement, arthroplasty is appropriate.

Significant neurological deficit (acute)

Cauda equina syndrome, progressive neurologic deficit, or acute myelopathy — these are surgical emergencies where movement-first is the wrong pathway.

Structural instability (ligament rupture)

ACL tears in young athletes with ongoing instability, or complete dislocations with soft-tissue incompetence — structure first, then movement therapy.

When surgery is right, KineticFirst is still relevant: post-operative recovery monitoring, RTM billing, and the data trail that shows your surgeon how recovery is progressing at home.

JointCoach — Remote monitoring

CMS RTM codes 98985/98979 · MediaPipe tracking · adherence data

SurgeonValue — When surgery IS the answer

Connect patients with orthopaedic surgeons who track outcomes

The System

The Kinetic Care Loop

Five layers. Each one makes the others stronger. The loop runs continuously — every step generates data, every data point generates care, every care event generates savings.

directions_walk

Layer 1

Movement Data

Wearables, gait analysis, phone camera, caregiver observation — captured at home, not in a lab.

psychology

Layer 2

AI Analysis

Sage identifies gait changes, flags risks, generates home exercise programs, and prepares clinical summaries.

stethoscope

Layer 3

Clinical Oversight

SurgeonValue RTM agents bill 98975–98981. Physicians review AI summaries and sign off in minutes, not hours.

home_health

Layer 4

Home Care

co-op.care worker-owned caregivers support movement goals at home — W-2 employees with equity, not gig workers.

savings

Layer 5

Financial Unlock

Letters of Medical Necessity unlock $936+/year in HSA/FSA. RTM billing generates $1,642/patient/year for your surgeon.

directions_walk

Layer 1 of 5

Movement Data

The loop starts with movement data — but not in a clinic. KineticFirst captures gait through the tools people already have: phones, fitness watches, and trained caregiver observation.

Why at home matters: Gait in a clinical setting is performance. Gait at 6am on the way to the bathroom is truth. Home-captured movement is the most predictive data in medicine.

Key metrics captured: Step count, gait speed, stride symmetry, double support time, TUG test, and 10-Meter Walk Test results.

0.8 m/s

Gait speed threshold — below this, hospitalization risk rises sharply

Why Movement

Gait tells the truth
before symptoms do.

The same neural circuits that control walking control cognition, balance, and cardiovascular function. Changes in how you walk often precede a diagnosis by 2–5 years.

elderly

Fall Risk

TUG > 12s

Timed Up and Go above 12 seconds indicates elevated fall risk. Above 20 seconds: high risk. This single test is more predictive than self-reported balance.

monitor_heart

Mortality Prediction

87% accuracy

Gait speed at age 75 predicts 10-year mortality with 87% accuracy — better than cholesterol, BMI, or blood pressure alone.

cognition

Cognitive Decline

2–5 years

Dual-task gait changes (walking while talking) detect cognitive decline 2–5 years before clinical diagnosis of MCI or dementia.

healing

Surgical Recovery

12–24 mo

Post-knee-replacement gait doesn't fully normalize until 12–24 months. Most patients are discharged at 6 weeks without monitoring. KineticFirst closes that gap.

table_chart Conditions KineticFirst monitors

Condition	Gait pattern	What to watch	RTM eligible
Hip/knee OA	Antalgic — shortened stance on painful side	Asymmetry index, step length delta	Yes
Post-hip replacement	Trendelenburg — contralateral pelvis drops	Hip abductor strength, lateral trunk sway	Yes
Parkinson's disease	Shuffling — reduced arm swing, festination	Step width, freezing episodes, turn time	Yes
Spinal stenosis	Neurogenic claudication — stops to rest	Walking distance before pain, flexion posture	Yes
Stroke (hemiplegia)	Circumduction — hip hikes to clear foot	Velocity, cadence, symmetry ratio	Yes

For Clinicians

RTM billing. KineticFirst does the work.

Remote Therapeutic Monitoring (RTM) codes 98975–98981 allow orthopedic surgeons and PTs to bill Medicare for home movement monitoring. Less than 0.2% of eligible patients are currently enrolled. KineticFirst automates the data collection and connects to SurgeonValue's billing agents.

98975 — Initial set-up $19

98977 — Monthly device supply $55

98980 — Treatment management, first 20 min $50

98981 — Additional 20 min $38

Annual RTM revenue per enrolled patient

$1,642

SurgeonValue →

AI-Generated

Home Exercise Program

Week 3 of 12

Patient

Margaret T. — Post-TKA, Right Knee

fitness_center

Terminal knee extension

3 × 15 reps · resistance band · 2× daily

Done

directions_walk

10-minute walk

flat surface · note any pain or limp

Done

stairs

Stair step-ups

2 × 10 reps each leg · handrail ok

Next up

Sage note: Step symmetry improved 8% since last week. Advance to stair protocol today.

moving

Start the loop today.

Talk to Sage about your movement goals, your surgical recovery, or how to enroll your patients in RTM billing.

For clinicians →

Surgical concern

Need a surgeon? SurgeonValue connects patients with orthopedic surgeons who track outcomes.

surgeonvalue.com →

PT / Recovery

Post-op rehab, RTM tracking, home exercise programs — physician-supervised recovery at home.

jointcoach.com →

Home care

Recovery support at home from worker-owned caregivers. HSA/FSA eligible via Letter of Medical Necessity.

co-op.care →

Medical disclaimer. KineticFirst provides general educational information about movement, recovery, and remote therapeutic monitoring. It is not a substitute for professional medical advice, diagnosis, or treatment. Movement data and AI analysis do not constitute clinical diagnoses. Always consult a qualified healthcare provider before beginning any exercise program or making decisions about your care. In an emergency, call 911.

80% of orthopaedic conditions
respond to structured movement.
Surgery is right for 20%.

What gets better with movement.
What still needs surgery.

The Kinetic Care Loop

Gait tells the truth
before symptoms do.

RTM billing. KineticFirst does the work.

KineticFirst is the front door.
The ecosystem does the rest.

Start the loop today.

Your movement is medicine. Get the science.

80% of orthopaedic conditionsrespond to structured movement. Surgery is right for 20%.

What gets better with movement.What still needs surgery.

The Kinetic Care Loop

Gait tells the truthbefore symptoms do.

RTM billing. KineticFirst does the work.

KineticFirst is the front door.The ecosystem does the rest.

Start the loop today.

Your movement is medicine. Get the science.

80% of orthopaedic conditions
respond to structured movement.
Surgery is right for 20%.

What gets better with movement.
What still needs surgery.

Gait tells the truth
before symptoms do.

KineticFirst is the front door.
The ecosystem does the rest.