Augmented Reality Platform for Telehealth Rehabilitation

新冠肺炎全球大流行施加的限制继续改变着交付和获得 全国范围内的医疗保健。由此产生的未得到满足的健康需求在老年人中产生了不成比例的影响 美国人仍然是新冠肺炎最新变种的最高死亡风险人群。其他内容 由于种族、性别、居住地点和收入而造成的健康差距因新冠状病毒而加剧， 进一步限制在整个生命周期内平等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和其他应用程序促进了远程 患者-临床医生视频会议作为远程医疗最常见的形式，它们几乎不能直接提供 评估肌肉骨骼(MSK)缺陷、计划治疗干预措施所需的体检， 或指导锻炼依从性--康复中循证实践的基本组成部分 从业者。这对于获得关节活动度、对齐、姿势、平衡、 骨性关节炎(OA)疾病的力量和功能；计划治疗干预的基石 和指导锻炼的遵从性。我们的生物机械师和计算机视觉工程师团队将继续我们的 第一阶段与马萨诸塞州综合医院的整形外科和老年康复专家合作 (MGH)推动增强现实(AR)平台的开发，使临床医生能够可视化 在视频会议期间加强远程远程医疗互动的关键康复成果措施 他们的病人。我们的第一阶段工作演示了标准3D摄像机在 当与后处理主体结合时，常见的消费设备(例如智能手机和平板电脑/PC) 跟踪算法可以为膝骨性关节炎患者提供准确的康复结果测量 模拟远程医疗访问。在第二阶段，我们将扩展我们的3D身体跟踪算法和AR平台 架构以支持更广泛的评估协议集，以适应不同的人和 家庭环境因素(目标1)；实现符合HIPAA的实时跨平台部署 在临床医生的屏幕上交流和展示结果(目标2)；在以下过程中验证原型 由诊所物理治疗师和远程家中的膝骨性关节炎患者参加的会议 覆盖城市、郊区和农村地区(目标3)。利益相关者将完成以下项目的自我报告调查问卷 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。 我们的里程碑是临床上可行且操作有效的AR远程医疗平台原型 受到临床医生和患者的好评，可在家中使用。长期影响将扩大获得 使用远程保健工具的康复专家，这些工具提供对肌肉骨骼的循证评估 在高危人群中指导治疗干预所需的不足。

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.