Rehabilitation through VR Tapio Jakobsson, 21.9.2017
Jan 23, 2018
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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Questions?
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Tapio Jakobsson
+358 50 440 6552