From vibrating posture sensors and gait-correcting shoe insoles to popular movement tracking devices like the fitbit, there have been a number of exciting advancements and trends in PT technology. These innovations offer new opportunities for improved diagnosis, treatment, and outcomes.
Smartphone and tablet apps for physical therapy professionals and patients are a growing trend. Many apps are inexpensive—or even free—and provide handy resources like physiotherapy glossaries, exercise videos, orthopedic diagnosis tools, clinical tests, and even 360-degree visual anatomy. Other apps, like PTGenie, are designed to assist patients with their home exercise programs (HEPs). With printable and emailable exercises, pictures, protocols, and evaluation forms, these intuitive apps help clinics save time and money while improving patient compliance.
Exoskeletons Are No Longer Science Fiction
The Berkeley-based company Ekso Bionics broke new ground in rehabilitation services and gait training when it developed the Ekso suit—an aluminum and titanium exoskeleton that helps patients suffering from varying degrees of paralysis or hemiparesis with movement. The suit helps facilitate patient progress with progressive step modes and enforces normal biomechanical alignments and gait patterns. Even more impressive, patients typically start walking during their first session with the Ekso suit.
Once the therapist “buckles in” the patient, he or she can choose from three walk modes. The first mode requires the therapist to actuate steps with the simple push of a button, while the second and third modes give control to the patient, who can actuate steps by using the buttons or shifting his or her body weight. Designed to meet the needs of busy therapists, the Ekso suit does most of the work, allowing the therapist to assist many patients in a short amount of time.
Robotics that Dramatically Improve Patient Progress
Rehab therapists are increasingly able to use rehabilitation robots to speed recovery for patients with such neurological impairments as traumatic brain injuries, strokes, and cerebral palsy. Practice makes permanent, and in PT, practice—repetitive movement—is key to recovery. Robots increase the number of repetitions performed by PT patients; in fact, a robot can help a patient perform ten times the number of repetitions in a normal one-hour session.
You’ve probably heard of anti-gravity and underwater treadmills, but get ready for Lokomat, a robotic treadmill that allows patients who suffer from neurological conditions to engage in task-specific repetitive movement, thus helping them regain or improve their ability to walk. (Rusk Pediatric Physical Therapy department in New York is already using this cutting-edge treadmill.) To use this innovative piece of equipment, the therapist suspends the patient over the treadmill using a harness. Then, the therapist fits the patient’s legs into the treadmill’s robotic legs. A computer then personalizes the pace of the treadmill and measures the patient’s response and progress.
From Gaming to Rehab
Over the last few years, more and more therapists have started incorporating the Nintendo Wii into treatment plans and HEPs. Wii games use motion-sensitive controllers and repetitive movements similar to the exercises performed in physical therapy. As a complement to traditional PT modalities, Wii-Hab—as it’s come to be known—is a proven way to better engage patients in their recovery and ease the burden of PT in clinical settings. The benefits of Wii-Hab extend to home exercise programs, too, because patients are more likely to participate in their HEP if they enjoy it.
Telemedicine is a growing trend in the physical therapy space and—again—video game technology has laid the groundwork for advancement. Companies like Canada’s Jintronix and San Diego’s Reflexion Health used pre-existing gaming technology to create web-based therapy programs founded on evidence-based practice. Reflexion Health’s Rehabilitation Tracker program provides prescribed patient-specific instructional videos, coaching, educational materials, and exercises. The program not only allows therapists to monitor patient performance and track patient progress in real time, but also enables them to physically see their patients performing the exercises using the Kinect camera.
Effective PT will continue to involve a strong, motivating rapport between the patient and the Physical Therapist. What is striking about the new advances in robotics and bionics is that bond can be strengthened by the faster and strong recoveries that this equipment provides. Patients who are energized by faster and perhaps strong improvements leads to far better patient experiences and improved outcomes. Some may argue that the risks of technology innovation in general is as great or even greater than the benefits they provide, but in the area of physical therapist is it quite clear that the growing number of new tools are a godsend for patients and allied health professionals who treat them alike.
Robert Hoyt, Ph.D.
Allied Health Professionals