Tapio Jakobsson, Physilect “Rehabilitation Through VR” - Mindtrek 2017

Rehabilitation through VR Tapio Jakobsson, 21.9.2017

• Ineffective rehabilitation causes enormous costs to the society

• €350 million is KELA’s annual rehabilitation budget (2015)

• Population is getting older • Falls (hip fractures) cause €183 million bill to

the society in Finland only*

Prerequisites

* Source: VTT

Trends and challenges in healthcare

Population ageing

- Duplication number of over 75 years old by

2040, 420.000 → 950.000 *

- Increasing labour shortage

Cost pressure of public healthcare

Decreasing number of institutional care

beds and increasing number of home care

patients

High number of stroke and other

neurological patients

High need of post-operation rehabilitation

Increasing pressure to utilize latest

technologies e.g. in remote rehabilitation

Need of new

treatment

methods and

tools, that allows

more

rehabilitation

done at homes

*. Statistics Finland, Medgroup

New technologies for rehabilitation Soft exoskeletons • to assist people with limited abilities • expensive, applied to very specific purposes

Exergames • to boost patient's motivation and engagement

Assistant robots • to allow remote rehab without physiotherapist’s presence

Wearable sensors • instant biofeedback • very accurate tracking of specific part of the body

Non-wearable motion tracking • instant biofeedback • cheap and very easy to use • accurate enough for most applications in rehabilitation

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Current state of rehabilitation in Finland

• Rehabilitation is based on professional knowledge

• Virtual rehabilitation is not used systematically

• Remote rehabilitation

- Increasing interest towards remote rehabilitation - Emerging technologies are not widely used in Finland - Real-time video streaming is accepted as standard for remote

rehabilitation

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Reseach: virtual reality games for seniors

• Positive clinical effects of virtual reality games for balance and mobility improvements

– Cognitive and motor skills training

– Cost-effective method

• Positive impact on fall prevention

• “Virtual reality games were superior for improving balance and fear of falling compared with traditional interventions in an elderly population”

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Source: Neri, S. G., Cardoso, J. R., Cruz, L., Lima, R. M., de Oliveira, R. J., Iversen,

M. D., & Carregaro, R. L. (2017). Do virtual reality games improve mobility skills and

balance measurements in community-dwelling older adults? Systematic review and

meta-analysis. Clinical Rehabilitation, 0269215517694677.

Physilect A perfect mixture of exergame and virtual assistant using non-wearable motion tracking

• boosts patient's motivation • allows remote rehabilitation without physiotherapist’s

presence • helps designing patient specific rehabilitation program • provides instant biofeedback to correct the performance • affordable and very easy to use in home conditions • allows remote follow-up by a physiotherapist

• Doctor – Correct diagnosis

• Physiotherapist – Proper selection of exercises – Rehabilitation plan – Follow up and adjust the plan upon the progress

• Patient – Regular exercises – Correct execution

Ideal course of treatment

25 out of 30 patients, when left alone, do their exercises irregularly and incorrectly Why irregularly? => Motivation Why incorrectly?

Real life

Typical instructions

Printout from commercial exercise library

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Source: www.physiotools.com

Demo

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Skeleton Model Graph

Skeleton Joint

Sensor Tracking Sector

One or two Microsoft Kinect sensor(s)

Skeleton Model Data Flow

Technology

The patient’s view

The physiotherapist’s view

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Basic functionality of Physilect

•Easy to follow exercise program •Real time biofeedback to the patient •Exercises could be easily adjusted based on individual need •Game mode allows most of the exercises to be done in game mode (with different types of games) • -> increases motivation

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Stabilect

• Virtual balance board • Standard balance tests

without special equipment

• Measuring balance and center of mass separately or during exercises

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Testing/diagnostics

• Testing/diagnostics allow to measure each patient ability to move

- Measuring angles of the joints

– e.g. knee bending angle

- Monitor progress of rehabilitation - Adjust exercises based on individual needs

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Motion lab

•Internal productivity tool –Allows to digitalize easily new exercises to Physilect’s exercise library

•Preventive injury diagnostics tool –Ability to track and analyze movements of patient very carefully

Example: recorded jump

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• Neurology – Post-stroke rehabilitation, Parkinson, Cerebral palsy, MS,

etc.

• Orthopedy – Post-operational and post-trauma rehabilitation

• Geriatry – Rehabilitation of seniors. Fall prevention.

• Occupational health – Musculoskeletal disorders are common for office workers

Applications

• Total product development effort so far about 20 men years

• 100+ exercises digitized to the Physilect library

• Balanced team – Seasoned IT entrepreneurs engaged – Expertise in physiotherapy

• Several pilots currently going on – Fysios Group (Lappeenranta) – Tampere University Hospital – Neuron (Kuopio) – Vetrea Terveys Oy (Kuopio, Joensuu)

Current state of the development

• Physilect Professional – installed at customer’s premises – two Kinects

• Physilect Home – installed at patient’s home – one Kinect

Product alternatives

Benefits of the solution

•Shortening hostipal / institutional care stays •Reducing risks of re-admission •Decrease number of face-to-face appointments •Constant monitoring of one’s rehabilitation process •etc. Main benefits: •Improves efficiency of rehabilitation •Saves healthcare cost

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Example

•Stroke patient exercises

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Questions?

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Tapio Jakobsson

Tapio.jakobsson@physilect.com

+358 50 440 6552