JMIR Publications

ABSTRACT

Background:

Understanding and assessing patients’ body movements is essential for physical rehabilitation but is challenging in video-consultations as clinicians are frequently unable to see the whole patient or see the patient performing specific movements.

Objective:

The objective of this exploratory study was to assess use of readily available technologies that would enable remote assessment of patient movement as part of a video-consultation.

Methods:

We reviewed literature and available technologies and chose four technologies (Kubi and Pivo desktop robots, Facebook TV portal, wide-angle webcam) additional to help from a friend or a simple mobile phone holder, to assist video-consultations. Five standard assessments (Sit to Stand, Timed Up and Go, Berg Balance Test, ankle range of motion, shoulder range of motion) were used as the ‘challenge’ for the technology. We developed an evaluation framework of six items: efficacy, cost, delivery, patient set-up, clinician training and guidance, and safety. Co-authors, including 10 physiotherapists, then took the roles of clinician and patient to explore seven combinations of five technologies. Subsequently we applied our findings to hypothetical patients based on researchers’ family members and clinical experience.

Results:

Kubi, which allowed the clinician to remotely control the patient’s device was useful for repositioning the tablet computer camera to gain a better view of body parts but not for tracking movement. Facebook TV portal was useful but only for upper body movement as it functions on face tracking. Both Pivo, with automated full body tracking using a mobile phone, and use of a wide-angle webcam for a laptop or desktop computer, show promise. Simple solutions such as having a friend operate a mobile phone and use of a mobile phone holder also have potential. Set up of these technologies will require better instructions than are currently available from suppliers and successful use will depend on technology readiness of patients and, to some degree, of clinicians.

Conclusions:

Technologies that may enable clinicians to assess movement remotely as part of video-consultations depend on the interplay of technology readiness, the patient’s clinical conditions and social support. The most promising off-the-shelf approaches seem to be use of wide-angle webcams, Pivo, help from a friend or a simple mobile phone holder. Collaborative working between patients and clinicians is needed to develop and trial technological solutions to support video-consultations assessing movement.