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interACTION: Improved Rehabilitation with a Wearable Monitoring and Training Tool

Detailed Technology Description

None

*Abstract

BackgroundInjuries to major joints such as knees, shoulders, elbows or neck require either surgical or conservative treatments. After surgical interventions or during conservative treatments, patients are referred to a physical therapist to conduct therapy sessions to restore the jointΓÇÖs normal range of motion (ROM). These therapy sessions are conducted a few times a week for several weeks during which the therapist performs a series of manipulations and motion based exercises to restore the jointΓÇÖs motion and normal levels of joint activity. This intervention is typically performed for one hour during each session, and the patient is sent home with a series of recommended home based exercises to strengthen the muscles around the joint and continue the therapy while outside the clinic. During the period of physical therapy, the therapist only interacts a few hours a week with the patient. Otherwise, the patient is left with minimal guidance and no feedback about his/her performance outside the clinic. The patient has to perform activities of daily living in addition to the recommended exercises, without receiving any feedback from the therapist about their performance or condition. Moreover, after the patient leaves the physical therapy clinic, the therapist doesnΓÇÖt have any knowledge about how the patientΓÇÖs daily condition or if he/she is complying with the recommended exercises. They cannot assess if the patient is performing the motions correctly and not causing more damage to the joint. Therefore, during the time gap between the clinical visits, neither the patient, nor the therapist has any information regarding the condition and the progress of the jointΓÇÖs recovery.TechnologyinterACTION is a joint function monitoring and training tool consisting of a wearable motion capture device (2 wireless inertial measurement units (WIMUs)/joint) and a web-based software application for managing and communicating joint motion data. Sensors placed on either side of a joint collect data regarding the motion of the knee and store it in a smartphone or tablet. This data is then analyzed and displayed in a customizable, joint-specific manner in patient and therapist modes. The patients follow personalized exercise programs, receive interactive guidance from their physical therapist, and view their progress with recovery. The web-based software allows local or remote therapists to follow the patientΓÇÖs progress over time, streamline utilization of clinical resources, and more efficiently provide care to a larger number of patients. The combination of the wearable device and the website, will give both patient and therapist the opportunity to continuously monitor the activity of the injured joint and alter the course of therapy to improve the chances of adequate range of motion joint recovery.ApplicationIn 2010 approximately 700,000 total knee replacements were performed in this country with over 1000 of these being performed in the UPMC Department of Orthopaedic Surgery (CDC, 2009). This market has grown 130% in the last decade with annual direct costs of approximately $20B and is projected to continue to grow even faster through 2030. Despite this large and growing market, limited joint motion after total knee replacement is relatively common, with 8-12% of patients experiencing motion deficits after surgery (Bong, 2004). The potential causes are numerous, and poor post-operative rehabilitation and compliance are frequently cited as a cause. By coupling rehabilitation monitoring with appropriate therapist feedback, interACTION aims to improve patient adherence and performance early in rehabilitation to promote faster functional recovery times with fewer complications. Advantages* Continuous monitoring of joint activity and range of motion.* Improved quality of care due to better therapist-patient relationships* Convenience of remote care via telerehabilitation* System is lightweight, self-contained and therefore mobile i.e. not confined to clinic or home as system can track joint movement during normal day-to-day living situations.* Cost effective (under $200)InterACTION is a tool that measures and guides knee motion for physical therapy that improves patient compliance in exercises performed at home compared to existing solutions which cannot provide quantitative, portable exercise tracking. Rehabilitation patients, physical therapists, orthopaedic physicians, and health insurers in vertically integrated health systems need interACTION to overcome changes in health care reimbursement which require treating and rehabbing knee surgical patients at a lower cost while demonstrating satisfactory patient outcomes. Stage of DevelopmentA benchtop prototype has been validated on asymtopmatic controls and a fully functional minimum viable product will be evaluated in a clinical trial in early 2015.

*Principal Investigator

Name: Bernard Bechara

Department: Med-Orthopedic Surgery

Name: Kevin Bell, MS

Department: Med-Orthopedic Surgery

Name: Robert Hartman

Department: Med-Physical Medicine & Rehabilitation

Country/Region

USA