Augmented Reality Platform for Telehealth Rehabilitation

2019冠状病毒病全球大流行所施加的限制继续改变了交付和获得， 全国各地的医疗保健。由此产生的未满足的健康需求对老年人造成了不成比例的影响， 美国人，因为他们继续处于COVID-19最新变种的最高死亡风险之中。额外 2019冠状病毒病加剧了种族、性别、居住地点和收入造成的健康差距， 进一步限制了在整个生命周期中公平获得医疗保健的机会。这些和其他挑战加速了 转向其他医疗模式，如远程医疗。然而，尽管Zoom和其他应用程序已经实现了远程控制， 患者-临床医生视频会议作为远程医疗最常见的形式，它们几乎没有提供直接的 评估肌肉骨骼（MSK）缺陷、计划治疗干预所需的体格检查， 或指导运动依从性-康复中循证实践的重要组成部分 从业者这对于获得关节活动性、对准、姿势、平衡的测量尤其如此， 骨关节炎（OA）疾病的强度和功能;计划治疗干预的基石 指导运动依从性。我们的生物力学和计算机视觉工程师团队将继续我们的 与马萨诸塞州总医院骨科和老年康复专家的第一阶段合作 (MGH)推进增强现实（AR）平台的开发，使临床医生能够可视化 关键康复结果措施，以增加远程远程医疗互动期间的视频会议， 他们的病人。我们的第一阶段工作证明了标准3D相机的概念验证， 普通消费者设备（例如，智能手机和平板电脑/PC）， 跟踪算法可以在治疗期间从膝关节OA患者提供准确的康复结果测量， 模拟远程保健访问。在第二阶段，我们将扩展我们的3D身体跟踪算法和AR平台 体系结构，以支持更广泛的评估协议，以适应各种各样的人类和 家庭环境因素（目标1）;实现实时跨平台部署，以符合HIPAA 在临床医生的屏幕上交流和呈现结果（目标2）;并在 涉及基于诊所的物理治疗师和膝关节OA患者远程位于家中的会议 城市、郊区和农村地区（目标3）。利益攸关方将填写自我报告问卷， 可用性、接受度和感知价值，然后是简短的指导性访谈和焦点小组评估。 我们的里程碑是一个临床上可行且运营有效的原型AR远程医疗平台， 被临床医生和患者有利地评价用于家庭。长期影响将扩大获得 康复专家使用远程医疗工具，提供基于证据的评估肌肉骨骼 在指导高危人群的治疗干预方面存在不足。

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, gender, 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.