For physicians
Specialty applications
The instruments are the same in every setting. The reason to use them is not.
Interventional pain management
Chronic metabolic inflammation — systemic, low-grade, driven by metabolic disturbance rather than by injury — alters both the generation and the perception of pain, and it damages exactly the tissues this suite measures. In a chronic pain population, the practical consequence is that a substantial share of patients have measurable small-fiber and autonomic abnormality that has never been assessed.
In the Padda Institute patient population the picture is starker still: fewer than 3% of patients overall, and fewer than 1% of chronic pain patients, meet the same definition of metabolic health. Those are practice-reported figures from our own population, not trial outcomes, and individual results vary. That figure describes a pain practice population and should not be read as a general-population estimate.
What changes: the patient with burning feet and normal imaging stops being a diagnostic dead end, and the metabolic contribution becomes a measured, trackable target rather than general advice. The patient-facing version.
Orthopedic surgery
Metabolic abnormality including obesity and type 2 diabetes is strongly linked to osteoarthritis and affects both weight-bearing and non-weight-bearing joints, which points at a mechanism more complicated than mechanical load alone. The perioperative relevance is separate and more immediate: perfusion, small-fiber integrity and glycemic status all bear on wound healing and on infection risk.
What changes: a preoperative assessment that measures perfusion and small-fiber function rather than inferring them, and an objective baseline for the large population of patients who are declined for surgery on metabolic grounds and then left without a plan.
Primary care
The base-rate argument applies most directly here. In a general adult panel, 12.2% of American adults met a full definition of optimal metabolic health in the National Health and Nutrition Examination Survey for 2009 to 2016 — so roughly 88% of US adults did not — so a protocol that triggers on overt abnormality will under-detect. The wellness visit already requires cognitive detection, fall-risk assessment and functional review; measuring them is a substitution rather than an addition. Annual wellness visit integration.
Psychiatry
Patients with major psychiatric disorders — schizophrenia, bipolar disorder and major depression — carry a higher risk of developing metabolic syndrome, including weight gain, obesity, disordered lipids, hyperglycemia and insulin resistance, which in turn raises cardiovascular, stroke and diabetes risk. Several of the medications used are themselves metabolically active, and several have anticholinergic effects that appear directly in autonomic and sudomotor measurements.
What changes: metabolic monitoring becomes measurement rather than an annual weight, and autonomic side effects of treatment become visible instead of inferred.
Cardiology
Peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity after coronary disease and stroke, and it is frequently asymptomatic because patients reduce their walking distance without noticing. Arterial stiffness and pulse waveform analysis add information the blood pressure cuff alone does not, and autonomic assessment is directly relevant to heart rate control, orthostatic symptoms and exercise intolerance.
Geriatrics and long-term care
The fall-prevention argument dominates here. 35.4% of US adults over 40 have measurable vestibular dysfunction, symptomatic individuals have twelve times the odds of falling, and falls remain the leading cause of injury death after 65. Pairing objective balance measurement with a cognitive baseline and a medication review is the highest-yield combination available in this population. Read more.
Talk to someone about testing
Tell us what you are trying to find out and we will explain which Measura assessments answer that question, what each one involves, and how the results are reviewed with a clinician.
4477 Woodson Rd, Suite 201, St. Louis, MO 63134. Monday to Friday, 9:00 a.m. to 5:00 p.m. Please do not send symptoms, diagnoses or images through a web form — a website form is not a secure medical channel. Call us with clinical detail.
Common questions
Which specialty gets the most out of this?
Primary care and geriatrics by volume; pain management by depth of finding. Why metabolic health belongs in a pain practice.
Is this useful before surgery?
Perfusion, small-fiber integrity and glycemic status all bear on healing, and all three are measurable non-invasively. What the assessments measure.
How does it fit a psychiatric practice?
As metabolic monitoring that is measured rather than estimated, plus visibility of autonomic medication effects. What insulin resistance looks like before diabetes.
References
- Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders. 2019;17(1):46–52. doi:10.1089/met.2018.0105
- Fowkes FGR, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013;382(9901):1329–1340. doi:10.1016/S0140-6736(13)61249-0
- Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001–2004. Archives of Internal Medicine. 2009;169(10):938–944. doi:10.1001/archinternmed.2009.66
- Kakara R, Bergen G, Burns E, Stevens M. Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021. MMWR Morbidity and Mortality Weekly Report. 2023;72(35):938–943. doi:10.15585/mmwr.mm7235a1
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed .