The Framework
The Steadfast Capacity Index™
A physician-led model that organizes your physiology into one integrated picture, identifies the Primary Restraint limiting you, and audits whether the right things are improving over time.
The SCI is not a single wellness score. It is a way of seeing how your systems interact, so treatment can start where it matters most.
What the SCI Is
The SCI is the clinical organization and measurement framework used within Capacity-Based Medicine. It integrates available objective and contextual data, clinical history, laboratory results, physiologic testing, symptoms, recovery, and performance, and organizes it across five capacity domains.
Its purpose is not to generate a simplistic health grade. Its purpose is to improve clinical prioritization, establish measurable baselines, and track whether the relevant areas of capacity improve over time.
We treat the physiology. We audit it with markers.
Five Capacity Domains
The SCI evaluates each patient across five physiologic capacity domains. These are not diagnoses. They are a consistent framework for understanding where capacity is strong and where it is constrained.
Oxidative / Mitochondrial
How effectively the body generates, sustains, and recovers usable energy through oxidative metabolism.
Relevant information may include metabolic efficiency, aerobic physiology, substrate utilization, nutrient sufficiency, cellular-energy markers, fatigue patterns, and recovery behavior.
Neuroendocrine / Autonomic
How effectively stress response, hormonal signaling, nervous-system regulation, sleep, and recovery support adaptation.
Relevant information may include hormonal patterns, autonomic balance, sleep quality, stress tolerance, symptom patterns, and recovery response.
Cardiopulmonary Delivery
How effectively oxygen and nutrients are delivered and used in support of physical and cognitive output.
Relevant information may include VO2, ventilatory thresholds, heart-rate response, oxygen pulse, recovery kinetics, cardiovascular risk, respiratory function, and conditioning.
Fuel Regulation / Metabolic
How effectively the body regulates, accesses, partitions, and uses glucose, fatty acids, and stored energy.
Relevant information may include glucose and insulin regulation, metabolic flexibility, body composition, lipid patterns, resting metabolism, fuel utilization, appetite, and energy availability.
Inflammatory / Regenerative
How effectively the body manages inflammation, injury, immune activation, tissue repair, and unresolved regenerative demands.
Relevant information may include inflammatory markers, pain, tissue dysfunction, immune burden, healing response, musculoskeletal limitations, and recovery capacity.
Derived From the Domains
The Primary Restraint
Most people have findings in more than one domain. The domains are the map. The Primary Restraint is the conclusion: the single domain currently placing the greatest limitation on your ability to recover, adapt, perform, or improve.
Secondary restraints may amplify the problem, but the Primary Restraint determines where treatment begins. It is derived from the full picture, not chosen from a menu.
Five Capacity Domains
SCI Analysis
Primary Restraint
Current Mission
The Steadfast Report
The SCI is delivered to you as the Steadfast Report: a physician-interpreted summary that answers three questions in plain language.
Where are you now?
A current read across all five capacity domains, including where capacity is preserved and where it is constrained.
What matters most?
The Primary Restraint: the single domain currently placing the greatest limitation on your capacity.
What are we doing next?
The Current Mission, the objective markers we are auditing, and the criteria that define success.
Steadfast Report
Capacity Summary
- Primary Restraint
- Fuel Regulation / Metabolic
- Primary Subcategory
- Substrate Utilization
- Current Mission
- Improve submaximal oxidative fuel utilization while preserving training capacity.
- Objective Capacity
- Improving
- Capacity Expression
- Improving
- Exit Criteria
- 2 of 4 achieved
- Next Reassessment
- 8 weeks
Fictional demonstration only. Values do not represent a real patient and do not expose the underlying scoring logic. The Steadfast Report answers where you are now, what matters most, and what we are doing next.
Optional, Illustrative
Tracking Change Over Time
Where it is useful, domain-level capacity can be represented on a simple relative scale to make reassessment easy to follow. This is a communication aid, not the point of the SCI. The goal is always the direction of change in the domains that matter, not a single headline number.
Steadfast Capacity Index™
An illustrative 0 to 100 view of usable physiologic reserve.
- Energy85
- Fuel68Restraint
- Cardio86
- Neuro90
- Inflam79
Raw average
82
Restraint penalty
-4
Adaptation
+6
SCI over time
Reassessed each panelSample values shown for illustration only. The SCI is a clinical organization framework, not a validated or population-standardized score, and it does not expose the underlying prioritization logic.
A Restraint Is Not a Diagnosis
A Diagnosis
Identifies a disease, condition, or pathology.
A Primary Restraint
Identifies the dominant functional limitation affecting adaptation, recovery, or performance at that point in time.
A restraint is not a replacement for a medical diagnosis. Both may matter, but they answer different questions.
Begin With Identification
Find the right way to begin Capacity-Based Medicine.