 In physical therapy, about 10 years ago, they started to push what was called evidence-based practice. And that was kind of a new thing, even though physical therapy falls within the medical field, there wasn't a ton of research done. So essentially, about 10 years ago, physical therapy kind of got turned on its head. We all said, wait a minute, is this working? Does what we do work? Let's figure this out. So there were the large-scale researchers within the institutions, and then there's all the clinicians that are out there working in the field. And I happen to be a little bit of both. I'm a faculty member where I have research requirements, but I'm at a small university where I don't have a large lab, and as a practice owner, I have the luxury within my practice then do kind of what I want, as Floadon has alluded to. So I incorporated a lot of research within my center to kind of help prove what we were doing was effective. So kind of the small scale with a little bit of the bigger scale. And that's something I really want to kind of bring to us. Now I know that research is not always the perfect after-lunch discussion. I know that perhaps not everybody was rushing back from lunch to get to talk about research. So I'm trying my best to spark your interest with some fancy animations. And it's almost that you can feel the hands coming out. I wish we could have 3D glasses. But to get into the world of Float, this weekend has just been amazing to hear all the amazing stories and amazing how passionate everybody is about Float. And that's really what I love about this community and being part of it. So let me ask you something I already know the answer to. Can you make this statement? I've met someone whose life has changed after Floating. So raise your hands. And it's pretty resounding, right? Now that's something that we hear all the time. Constantly, everywhere we turn, somebody's life has changed. But the next question is, can we make this statement? Research shows that rest rotation can change lives. And there's been amazing research. And I don't want to discredit any of that. Back with Sudefeld and Borey and all the way through to the current work of Dr. Feinstein, we are in an amazing historical moment, I think, where Float starts to really build up research and really become something that's in everybody's mind. So my hope is that with their hard work and then us kind of pitching in at the lower level research, we can in maybe two years have this response, right, where we're all feeling that we can definitely say this. So to kind of get there, right, we know that we have these amazing stories. And what I want to ask you to do is just take a quick second just to think what's your story? What got you here? What got you into Float? Or within your clinic or your facility, what is it that is kind of that driving force? Are you feeling like everyone that comes in say they slept better that night after? Or I have people coming in who have fibromyalgia and they're reporting that they feel better or chronic pain, right? So I'd like just to kind of think about what's happening in your world. One of the major prevailing things and we'll come back to that in a moment. But I know what you are thinking, right? Why should I care about research, right? And I get it, I get it, the research brings with it a lot of stress. A lot of people kind of have these connotations of research, man, I have to be in a million dollar lab and I'm gonna have to run statistics and none of us really likes statistics in school, right? But at the end of the day, it's appropriate to have kind of these insecurities when it comes to research, because we're really just like in our float tanks where we're delving into ourself, right? When we think about research, you're really delving into the world of float. You're delving into what makes float so amazing and what is the question that I can now look at and therefore make prove to be effective. So these insecurities, they go even with the greats. Even Albert Einstein was quoted as saying, if we knew what it was we were doing, it would not be called research, would it? Now, sure enough, there's some word play and he's a genius. I won't try to explain all of his word play, but research, kind of. So I think that's where he was getting at. But for me, I took it as even he questioned himself sometimes. And even he was looking at a question of significant form and saying, wait, am I doing this the right way? Am I looking at this the right way? And what's going through his head is all the different paradigms that come up when you think about research and all the different aspects. So this is a natural feeling and it's something that I feel every time I approach a research topic. So the answer is why? Why do we do this? Why do we put ourselves in this position? Why am I kind of coming here and pitching to everyone here that we should be more involved with research, even though we're not necessarily doctoral trained and we don't have PhDs and we don't necessarily have the statistics courses. Now, we do need those things and we do need them in order to do the high level research that's going to really make the major changes. But the high level research starts at the bottom. It starts with the ideas and it starts with the theoretical frameworks. So I'll kind of present to you how and why I think we can be a part of this and we can do this. Now, the why? It's pretty obvious. We've come up quite a bit. Actually, we're fortunate to hear Dr. Loretta Young discuss medical insurances and then the common language. So at the end of the day, when it comes to the mainstream population in schools, in sports teams, medical field, they want to hear this common language. They want to hear this works or this is effective at treating that. And that's kind of where we can start to drive the field. As opposed to having these amazing anecdotes, which we all have, maybe we could just change the terminology a little bit and say 75% of people with headaches improved after floating. So the how? Now, this is kind of the big question. And this is really where I guess I can kind of put my salesman hat on, although in the end I have a big sales pitch prepared for you. But for now, I kind of put my sales pitch. Research doesn't have to be as complicated as we think it is. So I look at a five-step approach. And I mean, I didn't make this, this is stolen out of a textbook, but now I look at it with this approach where you identify your research question first. Then you think about how you're going to do a study. At that point, you put together your methods, how it's all going to work. Then you do the study, you analyze the results, and you come together and you communicate with others in your field. And that's the driving force, that's what brings us forward. So to kind of put this in our world, the first one, identify the research question. Well, that's what you've already done. I asked you, what's your story? What do you see? So is it, I see people who have headaches feeling better. I see people who have insomnia sleeping better. I see children with cerebral palsy moving better, right? That's really your question at the end of the day. I see them doing this. Now, how can I show that it's really happening? As opposed to the person saying, oh, my headaches feel better. How can I say, 20 out of 30 people with headaches will feel better after floating, right? So you develop your question, and then you do a quick review. We're really fortunate now in the world of Google and Google Scholar, although I tell my students to stay away from it, I secretly use it myself. Google Scholar is as simple as it can be to search for research, right? It's a good starting point. You go on Google, you type in a topic, it does, flotation helps sleeping, and you'll get whatever research articles are available. And then you kind of break it down even a little bit further of, does meditation help sleeping? Does magnesium help sleeping? And then you kind of get lost in this, the internet of questions, right? And that's what I think really the complexity of research is and the beauty. When you start to think about that question, you start to think about all the different realms of that question. But that ultimately brings you back to your hypothesis, which is floating improves, the example here was sleep. People will sleep better after floating, all right? Then you come into your research design. Now, this is definitely something that can be very complex, but I'm not here to try to convince us to explore all these complexities. I'm here to say, let's focus on a small scale easy way to do it. And this is what I'm taking from my physical therapy background. A lot of the studies that we start off with in physical therapy, in the clinical setting, with PTs who have bachelors or masters or some doctorates, but not necessarily PhDs, we'll start with the quasi-experimental approach. And what that is that these aren't studies that are gonna make the drug companies turn their head necessarily, or the insurance companies turn their head. But what they are is they're quantifiable. And what we're doing is we're taking a pretest, that could be a questionnaire, it could be a manual test, then we're having the person float, and then we do that same test again, and then we compare the results. How do they do afterwards versus before? And that's research, right? Now, in order to do this, we need our method. The first part of our method is our outcome measures. And outcome measure is that tool, it's that survey that you give the person before and after. And when you do that kind of review on Google Scholar, you'll start to see, a lot of people, when they do their research studies on sleep, they use this sleep questionnaire. Let me use that sleep questionnaire, and that's kind of how you get there. But these questionnaires don't have to be scary. This is literally a very common questionnaire that's used in research studies, in physical therapy studies, neurological studies, pain management studies. It is simply a zero to ten scale. You give it to somebody before, you could theoretically give it to somebody before a float. Say circle, circle for me where you are on this scale. They circle a six, they float, they come out, you give it to them again. They circle this, they circle a three, now we have a change. And it's quantifiable, right? Okay. So, to go to the data analysis. Now, this is where things really can get technical, right? What my thought is, and this is where we've gone with a lot of my studies, is we don't need to do a full out statistical analysis to necessarily prove statistical significance. And when somebody can do that, and for that I think we're definitely looking to Dr. Feinstein for a lot of that for us. But when you can do that, that's what turns heads. But this type of study, this is what gets those heads looking in the right direction, okay? This is where we can do the studies, we could say beforehand a person was x, after they were y. I've done this with 500 people, and all of them improved. Or 90% of them experienced this improvement. And we can then use that as a jumping off point. And then, get in the research labs. And then we do a bigger study where we're using control subjects. And we're really taking a strong look at this. Then we get our quantifiable answers. So really, this smaller scale research is what can help drive us forward, okay? And then the key to all this is communication. And this is what I think really will help us as a field progress forward. The communication is us coming together. Perhaps in my vision, perhaps in a few years or next year, at a conference like this or on a website or somewhere, we can have a forum where we all kind of share the research that we've done. And we can say, well, I had four subjects, but those four subjects really showed this. Does anybody want to continue this study? Does anybody want to help me go to the next level here? And that's the key of all this. Now I do just want to clarify. So the research that I am proposing here. Is to demonstrate a theoretical framework and present a hypothesis. Now that said, we can still use this as a marketing concept. If we have 100 people float in our center and 95% of them report that they've improved their pain. There's no reason why you can't tell people 100 people floated here, 95% of them said their pain was better. That's absolutely appropriate. We're not making statistical claims. We're just making, we're telling them the history of our experience with our floaters. Now this kind of falls under the case study, case report area, and as you work your way up, you get into that randomized control trial, the meta-analysis, and that's where you really start to get the clear cut information that's going to drive us forward. But starting at this point gives us that discussion, and it gives us all the ability to kind of push us forward. So my only caveat, my only message that I have to, I feel responsible to convey is to be aware of bias. And this is something that I see on a daily basis, even in my own research where I've kind of mentioned to my partner, you know, I want to do this study, I think this is going to happen, and I'm choosing, you know, to do, measure it with this scale and that scale and this scale. And as I'm talking, I notice that I'm, I'm kind of even maybe choosing clients or patients that I know are going to fit that mold, right, and that's a form of bias. So the proposal, my proposal would be that you, you don't necessarily pick a mold. You, if, if you're doing pain, then every single person that comes in and checks off pain on your intake form, give them that pain scale and let them fill that out. And then, of course there's going to be a small bias because these people are coming into float. So there are people that are already interested in flotation. But it won't be a research bias, it won't be your bias. So you just want to be cautious about that. And then when you're presenting these findings, you want to tell people, this is our experience at our center, not necessarily making those big statistical claims or the medical claims that we're not quite ready to make with these kind of studies. So with that, I kind of bring my study. And so I intentionally did a small study. My goal was, it's a study that I did with a group of students at the college where I teach. We kind of wanted to focus on a small population to show that there was potential for change. And the reason I kept the small is because I wanted to pick very complex individuals or individuals that really need, you know, that could really benefit. And I'll explain that in a moment. So the literature review, so I had the idea. I said, I said, well, I want to study the effects of rest or effects of flotation on hypertenicity. I know that magnesium sulfate can potentially reduce muscle tension. So I want to study this and I want to see what happens in the neurological population where somebody's not just tight from a tough day, but they're tight from Parkinson's disease or multiple sclerosis. So in doing our lit review, I kind of came to the conclusion that spasticity leads to a decreased movement or hypertenicity. Magnesium can theoretically relax a muscle. And if I were to decrease that spasticity, as rated on a certain scale, the modified Ashworth, then I could improve a person's range of motion, posture, balance, self-care, speech, and on and on. So we chose our subjects. We took four people from different neurological conditions. One had Parkinson's disease, one had stroke, one had cerebral palsy, and one had multiple sclerosis. Now, all four of these individuals had a significant difficulty with movement. So they actually had to, it wasn't the perfect flotation environment. They actually had to be lifted in and out of the tank. So they had to wear bathing suits for the process. They had to actually have their family or their aides or their, you know, whoever assist them in life come in and assist them with showering before and after. But I chose these individuals because they were the people that I thought could really test my conclusions. You know, I could take a person that really has a lot of spasticity, so much that they're almost not able to walk. Now let's test them and see how much of a change we could see. So for our methods, to keep it simple, I've used the quasi-experimental pre-test, post-test design. And to kind of put my question in action, this is how it worked. So the procedure was the patient would come into the facility at the front desk, they would fill out their intake form. Now because I was working with people who had neurological conditions and because I had come into this with a research design to specifically assess individuals, I had to use an IRB, which is a institutional research board. I had to get reviewed and get approved. So that's where the consent form comes. Now if we're doing a study where anybody walks in off the street and we give them a questionnaire, that's not necessarily where we're administering research. That's something that's appropriate for us to do a questionnaire before and after. So in this case, there was a little layer of complexity. But the next piece was simple. The patient showered or the subject showered. They performed my pre-test. My pre-test was assessing how well they walk on a carpet that has assessment tools built in so it could assess how they walked. The timed up and go, which is a test where they go from sitting to standing, walk, come back and sit again and how long it takes them. And then Ashworth, which is the assessment of their specificity. So if we were to put this in the context of your question, when I oppose it to you, everything's the same up until here. So patient comes in, they fill out a form. They are getting ready for their float. Your pre-test that you're administering, whether it be a pain questionnaire, whether it be a sleep questionnaire, you administer that. They then move along. They get into the float tank. They float for 60, 90, 120 minutes. We did ours for 60 minutes. I wanted to do longer. But to be honest, I was a little anxious about the control of the environment and having an individual neurological condition in there unsupervised for that long. So I did 60 minutes with us nearby. Then the post-test. Sorry, that should say post-test. So afterwards, I did all of the same things I did for my pre-test. So I then sat down, had them assess their gait again, assess their ability to get up and walk again, and assess their ability to move without specificity. So my results. Now, this is four subjects, right? So I can't make these major claims. But what I can say is all four of the subjects showed an improvement in everything that I measured, which I think is pretty awesome. They showed reduced spasticity, which again, not just a tight muscle, but a neurologically spastic muscle that I had reduced. They showed that they were able to walk faster, walk with larger steps, walk at a quicker rate with each step. And ultimately, that they were able to get up out of a chair, walk back and sit down at a faster rate. So again, very simple statistical analysis. I just looked at before and after, and I put pretty lines. So the red was before, and this is for spasticity. So their muscles were very tight beforehand. And then afterwards, the yellow demonstrates how significant the reduction was. So these individuals had a reduction in their spasticity. And then the other one was velocity, where I took each subject and just showed what their speed was before and what it was after. And now we just have a visual of the fact that the patient's not necessarily just saying to me, I feel it's easier to walk. Now, we take that anecdotal evidence and we can put it more to results. And we could say, this patient's walking speed improved. And really, that's the crux of my discussion. That's the important piece that I want to relay is that we can start to have this common language where as opposed to having all the stories, which are amazing, we can now go a step further and put numbers and quantify these stories. Now, the important thing here is that I'm realistic. And I know this was four subjects, and this might not indicate that it would work for everyone. So I do say, I think we need to have more studies. We need a higher sample size. We need to get controls. We need to randomize this. And we need to really take it to the next level. But for now, I'm happy with these results. And then we'll build on it as the years go forward. Now, the take-home message. So to keep it simple, take-home message is I think we can do research. And I think we can do it in a formula of the quasi-experimental approach. And all of us can do it within our clinics where we just give a patient a questionnaire or maybe within mind, body, online, or helm, or whatever you use. Maybe we can convince those companies to embed some forms for us. And a patient comes in, if they have pain, that form automatically pops up and we have them fill it out. But we do our pre-test, we do our float, and then we do our post-test, and then we have numbers. So that's kind of my take-home message. Now, I'm not a salesperson. I'm a PT and I own a float business and we're all just so kind. And really, Ashkan and Graham have really sealed that one, right? We're all so kind, we're not necessarily selling people, we're helping people. But I figured I'm gonna give them my best shot. I'm gonna put my salesman's face on. So with independent research, and I went all out on this one, with independent research, float community will ultimately be able to come together and essentially reduce the amount of time it's gonna take for us to get to the point where we're having medical insurance cover it in America, that is, we're gonna be able to show that floating improves people's functionality. We're gonna be able to bring float all over the world. And ultimately, it's gonna help us make money for those that are in it for making money. Then when we come together and we share it with one another, we'll be able to reproduce it and we'll help everybody grow further. This is where the big sales pitch comes. I'm almost embarrassed to do it. So this means that you and I, we can have the world in our hands. So, thank you.