Physiotherapy is something that most of us will go through at some point in our lives. If you are involved in any form of competitive sport, it becomes close to a guarantee. But there are huge problems for both the practitioners and patients involved in making a physio programme a success. Personally, I have wide-ranging experiences of physio thanks to playing rugby at a competitive level in my younger years, which has resulted in many injuries - some of which I am still feeling today.
I’ve sat down with Dr Mark Elliott, Assistant Professor at the Institute of Digital Healthcare in WMG at the University of Warwick, to get a broader view of what he feels the challenges facing this area are and how digital health technologies are evolving to combat those challenges.
Physiotherapy in the UK under the NHS requires you to attend various one on one sessions with a clinician, where they will demonstrate certain exercises and stretches which you have to repeat at home, with just a pamphlet to guide you. This can prove difficult to achieve without someone there to prompt you and without the relevant feedback to say you’re doing the exercise correctly or regularly enough. It is one of the key areas Dr Elliott and his team are focusing on with their research into how Virtual Reality systems can guide people to engage and complete their therapy correctly. From my own experience, I’ve had the exercises demonstrated to me and then left for me to remember, with no real way to verify whether I am doing it correctly other than what I can remember the physiotherapist saying.
One technology that Dr Elliott uses for this research is Motion Capture. The technology that allows Andy Serkis to become Gollum, Caesar and Snoke has allowed physiotherapy exercises to be captured in detail. This movement data can then be mapped on to a virtual ‘avatar’ for playback. So, we have the movements captured and mapped on to an avatar that you can view... what next? Well, Dr Elliott and his team have created a virtual reality environment that allows you to be placed in a virtual space with the avatar. Here you can move around and view the avatar from every angle to try and mimic the movements as best as you can. There are still limits however, as there is still a disconnect between your physical self and the virtual world which you are placed. For example, you can’t look down and ‘see’ your hands and feet in the virtual world. In addition, virtual reality is not suitable for all, particularly those with balance issues where an immersive environment can cause disorientation.
The team at IDH are therefore looking for the next boundaries to push. When I asked where Dr Elliott saw the research heading, he very confidently answered with Augmented Reality. Being able to place the avatar in the real world around you would step up the immersion levels and overcome some of the barriers placed upon you with VR. As technologies such as Apple’s ARKit and Google’s ARCore become more powerful, Augmented reality will become a more viable option for projects such as this one.
The world is becoming steadily more accepting of digital technologies around healthcare. Physiotherapy is, perhaps, an ideal launchpad for getting wider acceptance of technologies such as Augmented and Virtual Reality. Indeed, mixed reality experiences are becoming more mainstream and the hardware associated with it is becoming cheaper and more common. Pretty much all computer graphics cards of the current generation from Nvidia (10 series and up) all support Virtual Reality to some degree; Apple’s iOS devices have ARKit included from 2017 onwards and select Android phones (Pixel brand devices and Samsung’s latest Galaxy S phones) have ARCore support from the get-go.
This brings me on to the smartphone and the wider arena of Digital Health as a whole. I asked Dr Elliott whether the smartphone, arguably one of the most constant parts of western life for the past decade, has been the standout catalyst for a lot of digital health projects. His reply wasn’t exactly a yes. The smartphone has a huge part to play and has had a large influence in certain areas of personal health and how that data gets captured and transferred. For example, his team are currently investigating the use of smartphone sensors to identify compensatory movements following injury, and examining how the data from smartwatches and other wearables can contribute to measuring workplace wellbeing.
Dr Elliott sees smartphone and wearable technology being able to provide continuous streams of health data that will allow us to identify sudden changes or early onset of diseases, but it also brings challenges to current health care systems in terms of how to capture and use that data. He believes that as more and more digital health technologies make it out to the mainstream, more people will want to transmit the data captured by these products back to their electronic health records. This is another challenge that members of the IDH team are focusing very heavily on, having recently being announced as a Midlands partner of the £30m Health Data Research UK initiative. In the near future, it should therefore become possible for us as consumers to easily upload any captured data to our own health record, be that physiotherapy exercises or blood sugar levels.
Digital health is likely to open up many new opportunities for patients to take control of their health in the next few years, and if technologies such as Augmented Reality and Virtual Reality continue to improve at their current pace, then the potential impact on a wider level for healthcare could be huge. If you are interested in how we are influencing the world of Digital Health, take a look at our company page.
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