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Given that many of these individuals have several chronic care, functional support, and social needs, maintaining access to the providers with whom they may have longstanding relationships can also be a very important factor in their willingness to accept a new system of care

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Gait abnormalities, modifications of biomechanics and systemic inflammation lead to joint degeneration, pain, and loss of function 103

While IGF-1 has important physiological functions, elevated levels carry potential concerns including increased cell proliferation that may support tumor growth in individuals with cancer or pre-cancerous conditions, accelerated aging processes through growth pathway activation, potential cardiovascular effects with chronic elevation, and metabolic consequences including effects on glucose and lipid metabolism