6 min readingPhysical therapy (PT) plays a crucial role in the management and rehabilitation of orthopedic conditions, particularly following surgeries, injuries, and overuse, often serving as an alternative or complement to surgical interventions. When evaluating patients’ and therapists’ perception of change following physical therapy in an orthopedic hospital’s outpatient clinic, 80% of patients and 73% of clinicians perceived a significant positive change (Swanenburg 2015). Physiotherapy positively impacts orthopedic outcomes by improving functional capacity and muscle strength (wright 1998). Furthermore, PT enables effective management of patients, improved patient satisfaction (Downie 2019, Daker-White 1999, Hockin 1994), reduced costs and waiting times (Weale 1995, Belthur 2003), reduced surgical referrals, and improved recovery times and surgical outcomes (Boxall 2004, Chan 2009). Psychological factors and patient expectations also play critical roles in determining the success of physical therapy interventions (Metcalfe 2005, Colaco 2009). Overall, a multidisciplinary approach that includes tailored physical therapy can lead to sustained improvements in patient health and mobility for episodes of care in orthopedic settings.
Despite its benefits, several challenges can hinder the effectiveness and delivery of PT treatments.In a world with growing demand for physical therapy and limited clinical staff, the availability and accessibility of PT services can become an issue. Geographic distances and health service policies can further accentuate this gap. PT effects may be task- and context-specific, meaning improvements in physical therapy exercises might not always translate to improvements in daily activities or other movements (Goede 2007). Additionally, chronic conditions may require long term PT for sustainable results. It has been demonstrated that, for chronic conditions, the decline in treatment effects after interventions suggests a need for ongoing, chronic treatment, which burdens an already overly burdened system. Moreover, chronic pain management requires a different approach than acute pain, focusing on building confidence and body awareness through gradual reactivation programs (Goede 2007). Some populations require special considerations, such as frail and older populations. In these populations, a “one protocol fits all” approach cannot be applied. Frail older adults with mobility limitations find it challenging to stay physically active, necessitating individualized, patient-centered PT strategies (Vries 2015). Lastly, physical therapists may face ethical dilemmas due to fiscally driven rules and regulations, which can compromise patient care (Richardson 2015).
Non-compliance is one of the most pervasive issues in physical therapy. However, in a study highlighting the problem of treatment non-compliance in physical therapy, the authors suggest that appropriately designed technology may be able to support patients and reduce the negative impact of this behavior. The authors stressed the importance of feedback and rewards based on exercise effectiveness and correctness, the need for improved exercise scheduling systems, and effective communication channels between patients and therapists (Chandra 2012).
Healthcare providers are increasingly integrating computer vision (CV) technology into orthopedic rehabilitation to enhance the effectiveness and efficiency of treatment programs. CV-based rehabilitation platforms harness gamification, meaning the application of game mechanics to non-gaming activities (Pandey 2022), to increase interactiveness and potentially provide real time feedback, corrective guidance, adherence and performance tracking.
CV in remote therapy models can provide multiple ongoing sessions at a fraction of the cost of traditional therapy, addressing the need for “chronic” treatment. Moreover, CV in remote therapy models minimizes challenges related to geographic distance, accessibility, and clinician availability. When combined with real time feedback, CV allows for individualized, patient-centered PT strategies. Strong CV platforms record patient performance and adherence data, which allows therapists to update treatment protocols to better suit patients and improve communication channels between patients and therapists. The benefits of CV are clear. It can offer added value to patients (increased effectiveness due to feedback and improved availability and accessibility ), therapists ( improved patient management resulting from adherence and performance data availability) and to health systems (reduced costs and wait times).
CV can provide tangible benefit to patients, therapist, health systems and is, in some cases, proving to be as effective as traditional treatment (Eisermann 2004) Thus, offering benefits that include improved monitoring, real-time feedback and corrective guidance, enhanced patient engagement and adherence, and the potential for remote therapy management, CV is a valuable tool in orthopedic rehabilitation. These advancements are paving the way for more effective and efficient rehabilitation programs, ultimately, for improved patient outcomes.
Resources
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