REMOTE PHYSICAL THERAPY:
ENHANCED RECOVERY THROUGH SYNCHRONOUS AUGMENTED ELECTRONIC INTERACTIONS
In the context of COVID-19, how might we provide a better remote interaction experience? How might we create meaningful interactions, both on and off the screen? How might we leverage gameplay to motivate daily engagement? How might we receive and transmit physical sensations between people? These and many other questions formed the basis of our design process and research.
Moments of mismatch
- Zoom call: in physical space, when someone looks directly at you and speaks, you can assume that what they are saying is directed at you. Over zoom, this dynamic breaks down, because we cannot sense where another person’s gaze is focused.
- Body language: webcam and video teleconference systems were designed to facilitate remote meetings, where most body language happens from a seated position. The optics in webcams are usually mounted on or integrated with a computer screen. This design is intended to work for subjects who are sitting within arm’s reach of the device. Physical activity requires greater distance.
- Touch: physical therapy is just that—it is physical. The lack of touch and physical interaction is a major obstacle to physical therapy in a remote context. We explored haptics and mixed reality technologies as possible interventions.
Existing technologies
Rec Room https://recroom.com/
- Design a figure/ image to represent users in a traditional video meeting
- Create a set of sign language to express emotions/ reactions
- Play games and interact with others in virtual space
YogAR https://www.producthunt.com/posts/yogar
- Yoga app for Microsoft HoloLens
- Provides a 3D learning experience through Mixed Reality(MR)
- Learners are able to see demo posture, footprints and handprints in space, hear audio instructions, and watch as relaxing videos guide them through each pose
Enflux Exercise Clothing https://www.kickstarter.com/projects/1850884998/enflux-smart-clothing-3d-workout-tracking-and-form
- Compression shirt and pants with ten embedded sensors to track users’ movement
- Smartphone app that collects data from the clothing, and analyzes your 3D movement in real-time
- Empowers users to replay earlier motions and to learn better form through feedback and repetition
- Collect metrics and data on workouts
Prototyping
To provide meaningful interactions between the physical therapist and patients, we considered a range of platforms and technologies. From our research and interviews, we found a need for better representation of touch beyond vibrating motors.
To address this, we considered using independent servo motors connected by high-strength nylon filament (i.e., fishing line) to recreate the feeling of pulling. This mechanism would be capable of wirelessly transmitting gestures for pose and form corrections. While not intended for a final end-user product, this approach helped us to consider other ways to include directionality to remote tactile feedback.
To grapple with the complexity of this large problem space, we decided to narrow our focus onto knee injuries and recovery. In our second pass of prototyping, we envisioned an intelligent knee-brace that could capture real-time movement data, and provide targeted haptic feedback to patients. This approach involved the use of embedded LRA (linear Resonant Actuators) devices and accelerometers. The placement of devices above and below the knee would allow for directional and three-dimensional haptic feedback to patients.
As we continued to explore this problem space, including additional interviews, we found that seamlessness is an important consideration. Bulky devices allow for including more robust features and integration, but at the cost of simplicity and wearability. This is an extraordinary drawback for patients who may desire an all-day wearable device, or something that can fit underneath their clothing.
For considerations of a 3rd-generation device, we focused on simplifying the placement and application of devices, as well as scalability. The initial question for this pivot in form was: how big is too big? My initial exploration was done in Fusion 360, and was based on the dimensions of medicated patches (e.g, “Icy Hot”).
Our second question: how small, and where on the body? While our consideration of a knee brace offered some flexibility, the use of a more modular system presents a much wider range of options. Physical prototyping and evaluation helped to narrow the scope.
This evaluation suggested that the dimensions for the adhesive patches needs some revision to operate well on this region of the body. The ultimate goal is to design nodes that are exactly as small as they need to be, but no smaller. The lower limit is critical.
BRANDING AND STYLE
As we continue to develop a vision for a system that augments remote physical therapy, we also considered the brand and appearance of the service and devices. The use of a light line-weight and black-on-white theme conveys our goal to make a discrete, lightweight system.
