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Edward Likovich is the CEO of Nymbl Science headquartered in Denver. Follow them on LinkedIn and learn more at nymblscience.com.
TELL US, WHO ARE YOU AND WHAT DO YOU DO?
Hi, I’m Ed Likovich. I’m the CEO of Nymbl Science and our mission is to prevent one million falls. We focus on the older adult population who we feel is often marginalized, and especially in this time of a pandemic, they are shut-in their homes and disconnected from a lot of services and things of that nature. Our mission is to challenge the belief that being older is less because it’s not. Being old is not a disease, it’s not a diagnosis; it’s a natural part of living. Our company aims to reach out to those folks and give them the tools they need to live healthy, productive lives and do so in the way that they want.
HOW DID YOU GET HERE?
Nymbl was initially founded by a now-retired spine surgeon, Dr. JP Farcy. Dr. Farcy was a rare type of surgeon. What I mean by that is he didn’t want to operate on just anybody. He wanted to operate on the people who would actually do better if surgery would help them. What he found in his research is that in doing spine surgery, a lot of people didn’t actually do better because of it. Their cases would look identical to others and he’d perform the surgery but then they just wouldn’t have great outcomes.
He determined that pre-surgical balance was a huge predictor of how well you did after spine surgery. In other words, if you had good balance going into the surgery and there was a problem with your spine and it was fixed, then outcomes were great. and you lived a great life. But, if you had bad balance and he fixed a problem with your spine, it didn’t really matter. You still couldn’t move very well because of your balance. That got him really interested in the idea of training balance and how to improve people’s balance. He stopped operating on people who had bad balance, which again is very rare for a surgeon.
He found that you could train balance most effectively with cognitive dual-tasking and that’s the centerpiece of what Nymbl does today. Existing balance classes focus exclusively on the physical aspect of your body. So you’re working on something, but you’re focused on what your ankles, knees, and hips are doing. The challenge is that when you’re focused on that, that’s your executive function. You’re focusing on a task and you’re learning that way – it’s a higher order.
Cognitive process balance is about a reflex, it’s about the brain and the body working together – it’s not just the body working alone. What Dr. Farcy found in his research is that by doing this thing called “dual-tasking,” which means you combine a physical challenge and a cognitive challenge, you could actually train that reflective aspect of balance and improve people’s ability to respond when they lose their balance, not just build leg strength.
What that means in terms of Nymbl is we take the increasing penetration of digital devices in older adult populations (about two in three people age 70 and older now have a smartphone or tablet in their home) and we deliver personalized balance training programs that employ dual-tasking. They do very simple physical activities while they’re unscrambling words, doing math problems, remembering shapes, playing little games, and because their attention, their cognitive focus is on that challenge, it forces that physical activity to be relearned in the cerebellum, which controls the reflex. We’re essentially able to train the reflective aspect of balance more effectively than any other solution out there.
WHAT DO YOU STAND FOR? WHY IS THIS WORK IMPORTANT TO YOU?
There are a couple of things. Number one, our core purpose is challenging. There is a belief that old is less; just because you’re old doesn’t mean you’re less of a person or that your voice matters less or that your life matters less. We’re all humans. We should all have equal dignity. We’re in this to help what’s an often marginalized population.
Our mission is to prevent one million falls. We like to talk about one million falls because nobody else is. Everybody else is still focused on the brick-and-mortar approach of sending people to the local YMCA and having them take an in-person balance class which great, but there are only 10 or 20 people in that at a time and that’s not easily scalable. We are using technology to reach millions of older adults who are shut in their homes and who don’t have access to wellness services.
The third thing that’s important to us is every one of us has a personal experience with a fall. For me, it was my grandfather. He fell and was never was the same afterward, never quite got back on his feet. It was a long, slow decline. Unfortunately, most Americans have a very similar story of a loved one. One in three older adults falls each year and it’s arguably the biggest impact for the older adult population from a cost and frequency perspective. Yet we have no sort of national strategy or intervention to support that right now. So we’re looking at that from a total population basis and thinking about how many people we can really reach and how many people can we help.
WHAT IMPACT ARE YOU MAKING?
Primarily, we’re helping older adults live the lives they want to live. We have a lot of stories. One woman came to us and she was basically shut into her home. She did Nymbl for a period of a month and she wrote to us and said, “I’m actually outside walking my dog again. And I don’t feel like I’m going to fall over when the dog pulls on me.” Think about how life-changing that is for somebody who was shut in their home, who cares deeply about her animals, and who is now out of her home and spending time with her two dogs that she loves so much.
Another woman came to us and said (this was pre-pandemic times when the world was all rosy), “There’s a family reunion coming up and I want to go to my family reunion. I want to be able to get on the airplane and gently walk down the jet bridge.” That seems so simple to you or me, but to her, that was a real goal. And she was able to do it because she invested in herself.
We don’t measure impact by telling people what to do, or by checking boxes, we measure impact by making ourselves available to older adults and meeting them in the place where they are and letting them consume Nymbl and our resources in the way that’s right for them. One older adult might be outside running a 5k and they just want to maintain their balance and make sure their golf game is great. Another might struggle to get up from a chair. Those two people need drastically different things, but the one thing they don’t need is somebody telling them what to do. They need support and they need education. They need to see what’s possible, and then they need to pick that up. We like to think of ourselves as empowering older adults in that process.
WHAT’S YOUR VISION, YOUR BIG DREAM FOR THE IMPACT YOU WANT TO MAKE?
I come back to our core tenants. Number one is the near-term goal of preventing one million falls. At this point, we’re preventing several thousand falls and so we’ve got a long way to go. The broader vision from there comes back to challenging the belief that older is less. There is a lot of help that older adults need in a system where things are often dictated to them or where information isn’t as readily available in ways that older adults prefer to consume it. We think about meeting them where they are in a variety of areas in their life beyond just falls. We don’t have any firm plans as to what that looks like right now, but we’re going to get there.
WHAT CHALLENGES ARE YOU FACING?
Our biggest challenge is that we want to move a lot faster than the world wants to move. A lot of what we do is work to integrate Nymbl into health plans, and there are some terrific health plans out there that we’re excited about, but it’s a long process to get started. It pains us to see the older adults out there right now who are stuck in their homes, who don’t have a solution like ours and who aren’t going to get something very quickly. Unfortunately, that’s the way that our system operates and I can understand wanting to vet things before we get them out there and wanting to make sure we have the right plan in place. Our challenge is that we want to move as fast as we can, but still respect that system of validation and checking and making sure we’re doing the right thing for all parties involved.
WHAT’S ONE THING YOU WANT PEOPLE TO KNOW ABOUT THE WORK YOU’RE DOING?
It’s the idea that most falls are preventable. There’s broad research consensus on this. It’s not some falls, it’s not a few – most falls are preventable. All too often, we hear stories from older adults who go to see their physician and their physician says, “I see, you’re worried about balance. Well, you’re getting older. That’s just normal.” It’s not ‘just normal,’ it’s something that you can work on. I think about older adults who believe that falling is normal and want them to know that there are actually a lot of things they can do to live a great life. I also want to encourage the kids and grandkids of older adults to support their older adults in this journey. A fall doesn’t have to be a fatalistic decline. And for the healthcare professionals out there, I want them to realize that older adults want help and they want to be listened to and they want to see what solutions are out there. It shouldn’t be as simple as, “You’re getting old, therefore things are going to decline.” We should be focused on helping older adults live the lives they want to live.
DO YOU HAVE A FAVORITE QUOTE OR WORDS OF INSPIRATION TO SHARE?
Our core purpose is to challenge the belief that old is less and realize that old isn’t less, old is just a different phase of life. We want to encourage a paradigm shift around the fact that older adults are not different than us, they’re just older. They have the same wants and needs as you and I do. That’s one of our key educational missions is helping to educate people that older adults don’t deserve to be in a corner all by themselves and be treated as different from everybody else, they’re just like us.
HOW CAN OTHERS SUPPORT YOU OR YOUR CAUSE?
Visit our website. We’d love for people to go there and learn more about what we’re doing. If you’re an older adult interested in balance training, talk to your health plan and tell them that you want Nymbl. If people want to help us develop new features, or participating in user research, please come to our website, use the Contact Us form, and let us know that you’re interested in helping and providing feedback. We love to hear from folks. Otherwise, support our belief that older adults aren’t less and that they’re in real need right now being in a higher risk group during the pandemic. We’ve got to reach out to older adults and make sure they’re getting what they need. And we have to remember, they’re just like us and that they’re just in a different phase of life and that they can live the life that they want so long as they’re connected with the right resources.
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