Augmented Reality Platform for Telehealth Rehabilitation

Restrictions imposed by the COVID-19 global pandemic have continued to alter the delivery of, and access to, healthcare across the nation. The resulting unmet health needs have had a disproportionate effect among older Americans as they continue to be at the highest mortality risk for the latest variants of COVID-19. Additional health disparities due to race, sex, residential location, and income have been exacerbated by COVID-19, further limiting equitable access to healthcare across the lifespan. These and other challenges have hastened the shift to other modes of healthcare such as telehealth. Yet, while Zoom and other apps have facilitated remote patient-clinician videoconferencing as the most common forms of telehealth, they do little to provide direct physical examination needed for evaluating musculoskeletal (MSK) deficits, planning therapeutic interventions, or guiding exercise compliance—essential components of evidence-based practice among rehabilitation practitioners. This is especially true for obtaining measures of joint mobility, alignment, posture, balance, strength, and function from osteoarthritis (OA) disorders; cornerstones for planning therapeutic interventions and guiding exercise compliance. Our team of biomechanists and computer vision engineers will continue our Phase I partnership with orthopedic and geriatric rehabilitation specialists at Massachusetts General Hospital (MGH) to advance the development of an augmented reality (AR) platform that enables clinicians to visualize key rehabilitative outcome measures to augment remote telehealth interactions during a video conference with their patient. Our Phase I work demonstrated the proof-of-concept that standard 3D-cameras available in common consumer devices (e.g., smartphones and tablets/PCs) when coupled with post-processing body tracking algorithms can deliver accurate rehabilitation outcome measures from patients with knee OA during a simulated telehealth visit. In Phase II we will expand our 3D body tracking algorithms and AR Platform architecture to support a broader set of assessment protocols that accommodate a diverse array of human and home environment factors (Aim 1); enable real-time cross-platform deployment for HIPAA-compliant communication and presentation of outcomes on a clinician’s screen (Aim 2); and validate the prototype during sessions involving clinic-based physical therapist and a person with knee OA remotely located in their home across urban, suburban, and rural locations (Aim 3). Stakeholders will complete self-report questionnaires for usability, acceptance, and perceived value followed by brief guided interviews and focus group evaluations. Our milestone is a clinically viable and operationally effective prototype AR Telehealth Platform that is favorably rated by clinicians and patients for use in the home. The long-term impact will expand access to rehabilitation specialists using telehealth tools that provide evidence-based evaluations of musculoskeletal deficits needed for guiding therapeutic interventions among at-risk segments of the population.