From vibrating posture sensors, gait-correcting insoles, and pressure-sensing socks to popular movement tracking devices like Fitbit, video game systems designed to make therapy more fun, and helmet sensors that alert athletes and medical professionals of potential concussion-causing hits, there have been a number of exciting advancements and trends in PT technology. These innovations offer new opportunities for improved diagnosis, treatment, and patient engagement.
iTherapy: There’s an App for That
Smartphone and iPad apps for physical therapy professionals and patients are a growing trend. Many apps are inexpensive—or even free—and provide handy resources like physiotherapy glossaries, exercise videos, orthopedic diagnosis tools, clinical tests, and even 360-degree visual anatomy. Other apps, like PTGenie, are designed to assist patients with their home exercise programs (HEPs). With printable and emailable exercises, pictures, protocols, and evaluation forms, these intuitive apps help clinics save time and money while improving patient compliance.
Bionic Boy—or Girl—Meets World
The Berkeley-based company Ekso Bionics broke new ground in rehabilitation services and gait training when it developed the Ekso suit—an aluminum and titanium exoskeleton that helps patients suffering from varying degrees of paralysis or hemiparesis with movement. The suit helps facilitate patient progress with progressive step modes and enforces normal biomechanical alignments and gait patterns. Even more impressive, patients typically start walking during their first session with the Ekso suit.
Once the therapist “buckles in” the patient, he or she can choose from three walk modes. The first mode requires the therapist to actuate steps with the simple push of a button, while the second and third modes give control to the patient, who can actuate steps by using the buttons or shifting his or her body weight. Designed to meet the needs of busy therapists, the Ekso suit does most of the work, allowing the therapist to assist many patients in a short amount of time.
Running with Robots
Another futuristic tool for rehab therapists, rehabilitation robots, assist therapists with exercises and can speed recovery for patients with such neurological impairments as traumatic brain injuries, strokes, and cerebral palsy. Practice makes permanent, and in PT, practice—repetitive movement—is key to recovery. Robots increase the number of repetitions performed by PT patients; in fact, a robot can help a patient perform ten times the number of repetitions in a normal one-hour session.
You’ve probably heard of anti-gravity and underwater treadmills, but get ready for Lokomat, a robotic treadmill that allows patients who suffer from neurological conditions to engage in task-specific repetitive movement, thus helping them regain or improve their ability to walk. (Rusk Pediatric Physical Therapy department in New York is already using this cutting-edge treadmill.) To use this innovative piece of equipment, the therapist suspends the patient over the treadmill using a harness. Then, the therapist fits the patient’s legs into the treadmill’s robotic legs. A computer then personalizes the pace of the treadmill and measures the patient’s response and progress.
They Tried to Make Me Go to Wii-Hab
Over the last few years, more and more therapists have started incorporating the Nintendo Wii into treatment plans and HEPs. Wii games use motion-sensitive controllers and repetitive movements similar to the exercises performed in physical therapy. As a complement to traditional PT modalities, Wii-Hab—as it's come to be known—is a proven way to better engage patients in their recovery and ease the burden of PT in clinical settings. (Even Adrian Peterson has used Wii-Hab to help him recover from a knee injury). The benefits of Wii-Hab extend to home exercise programs, too, because patients are more likely to participate in the HEP if they enjoy it.
Let’s Get Virtual
The use of video game technology in PT has extended into virtual reality rehab—an immersive, interactive therapy experience in a virtual environment. The University of South Florida (USF) recently obtained the same virtual reality (VR) technology used by the Department of Defense. As part of its study, USF uses the extended version of a VR system called CAREN—Computer Assisted Rehabilitation Environment system—to help patients who have suffered strokes or traumatic injuries, patients with disabilities, and the elderly to improve their sense of balance, coordination, and mobility. Though VR has been used in physical therapy for nearly a decade, CAREN offers new opportunities for advancing diagnosis and treatment of musculoskeletal and neurological disorders.
Kinect the Dots
Telemedicine is a growing trend in the physical therapy space and—again—video game technology has laid the groundwork for advancement. Companies like Canada’s Jintronix and San Diego’s Reflexion Health used pre-existing gaming technology to create web-based therapy programs founded on evidence-based practice. Reflexion Health’s Rehabilitation Tracker program provides prescribed patient-specific instructional videos, coaching, educational materials, and exercises. The program not only allows therapists to monitor patient performance and track patient progress in real time, but also enables them to physically see their patients performing the exercises using the Kinect camera.
Concussion management—and prevention—has been a hot-button topic for a while now. After all, more and more medical professionals are acknowledging the long-term risks associated with repeat and/or untreated head injuries. In 2010, Chase Curtiss developed Sway, a techy solution to help “health professionals...administer objective balance and reaction time testing in virtually any setting.” With Sway, PTs can not only ensure their patients are healthy on the field and off, but also make better care decisions to improve outcomes based on real-time objective data.
On a related note, Steven Wilkinson, PT, PhD—associate director of the physical therapy program at Rocky Mountain University of Health Professions in Provo, Utah—believes PTs in the not-so-distant future will be able to take advantage of wearables that alert them when a patient’s gait speed drops, so they can intervene before a patient experiences a fall. With FocusMotion software that enables developers to “produce usable data from movements captured by wearables and body sensors,” Wilkinson’s prediction probably isn’t too far off. Cavan Canavan—the company’s CEO and founder—told PT in Motion, "In the next five to 10 years, physical therapy will find complements and assistance from the emerging wearable ecosystem. Future wearables will be small, affordable, open, durable devices that will help patients, insurers, and PTs alike. These devices will be used to track patients both in and out of the clinic, while providing real-time interventions that prevent fatigue and injuries." Sounds good to us.
Physical therapy is, and always will be, a hands-on field, but that doesn’t mean technology can’t play a pivotal role. Advances in robotics and bionics help therapists diagnose more precisely, increase clinic efficiencies, and reach more patients. Furthermore, such technologies improve patient engagement and HEP compliance. All of this boils down to a better patient experience, which in turn can lead to improved outcomes. Talk about a level up.