Background

Bespoke Treatments is a multi-location physical therapy clinic operating in New York, San Diego, and Seattle, specializing in rehabilitation, fitness, and performance optimization. The clinic serves a diverse clientele, including recreational athletes, individuals recovering from injury, and those seeking long-term health improvements.

Challenge

Bespoke Treatments sought to enhance its service offerings by incorporating objective physiological assessments into patient care. The goal was to move beyond standard rehabilitation and introduce data-driven health optimization programs that could improve patient outcomes, increase retention, and create new revenue streams.

One of the key challenges was getting patient buy-in. Many clients initially sought treatment for pain or injury and were unfamiliar with metabolic health assessments. Educating them on the importance of a holistic, long-term approach was crucial. Additionally, the clinic needed to integrate these services without disrupting existing workflows.

Solution

Bespoke Treatments implemented PNOĒ metabolic testing to provide a comprehensive analysis of cardiovascular, pulmonary, and metabolic function. This allowed practitioners to:

• Use objective data to guide rehabilitation and fitness programming.
• Identify limitations and inefficiencies in a patient’s physiology.
• Personalize exercise, nutrition, and lifestyle recommendations.
• Track progress over time, reinforcing patient commitment.

PNOĒ’s structured reporting system and integrated nutritional support simplified the implementation process. It also served as an educational tool for clients, making complex physiological data more accessible.

Case Study 1: Post-Pulmonary Injury Recovery

A patient with a history of high-altitude sickness, pulmonary edema, and aspiration pneumonia underwent metabolic testing both before and after hospitalization. Initial results showed a VO₂ max of 52 ml/kg/min, but following the illness, this dropped to 37 ml/kg/min, indicating severe respiratory limitations.

Using PNOĒ’s test results, the clinic developed a safe, structured rehabilitation program focused on controlled zone-based cardio training to rebuild lung capacity. Over 12 months of guided intervention, the patient improved to 44 ml/kg/min and reached 53 ml/kg/min after 18 months, surpassing his pre-injury fitness level.

This case demonstrated how data-driven rehabilitation enhances patient trust and retention, ensuring continued engagement in long-term health programs.

Case Study 2: Optimizing Performance and Body Composition

A recreational athlete sought treatment for knee pain but expressed a broader interest in improving fitness and reducing body fat. His training regimen consisted solely of high-intensity boot camps five to six times per week, leading to metabolic inefficiencies.

PNOĒ testing revealed imbalanced energy utilization and a lack of aerobic efficiency. A revised training plan incorporated:

• Two days of low-intensity steady-state cardio to enhance fat oxidation.
• Two days of strength training to improve muscle mass and metabolism.
• Two days of high-intensity training, maintaining his preferred activity.

After two months, he reported increased strength, improved cardiovascular endurance, and reduced body fat, demonstrating how objective data can guide smarter training decisions.

Case Study 3: Chronic Pain and Weight Management

A patient with hip osteoarthritis, labral tears, and chronic pain resisted a recommended hip surgery and instead pursued rehabilitation. After a year of mobility and strength-focused therapy, she expressed an interest in weight management and returning to dance.

PNOĒ’s resting metabolic rate (RMR) test was used to establish her true caloric needs. A food log comparison revealed she was eating at maintenance levels, despite believing she was in a calorie deficit. Small dietary adjustments resulted in gradual weight loss and increased energy levels, reinforcing how objective metabolic data can improve nutritional adherence.

Business Impact

The integration of PNOĒ transformed Bespoke Treatments’ business model by expanding service offerings, improving retention, and attracting high-value clients.

• New Revenue Streams: Metabolic testing was offered as a standalone service ($150–$300 per session) or bundled into treatment packages ($600+ per program).
• Higher Patient Retention: Clients transitioned from short-term rehab cases to long-term wellness programs, extending engagement from weeks to 6+ months.
• Stronger Client Buy-In: Personalized metabolic reports and data-driven recommendations reinforced trust and commitment to treatment plans.
• Competitive Advantage: Positioning as a data-driven, holistic care provider attracted more high-performance clients and professional referrals.

Conclusion

By integrating PNOĒ metabolic testing, Bespoke Treatments enhanced patient outcomes while increasing revenue and long-term engagement. The ability to objectively measure and track physiological changes strengthened patient adherence, optimized treatment strategies, and differentiated the clinic in the competitive rehab and wellness market.