Hollywood tech lands a leading role in health care

PT is having an ET moment.

Tech is starting to find its way into physical therapy, as the tools that helped animate Gollum in "The Lord of the Rings" series of films are now allowing you to get a trainer-supervised workout in your living room.

Here's what it looks like: You turn on a TV and start a special program from a company like Reflexion Health, which makes a system called Vera that connects to two cameras you stand in front of. One records your movements for a clinician to watch while the other tracks your body's joints.

Unlike in the movies, where that kind of information is used to help animate a computer-generated character, these programs show how well you're doing various exercises.

With Reflexion, you watch an avatar clad in blue and black workout gear -- named Vera, or Virtual Exercise Rehabilitation Assistant -- as she demonstrates proper exercise form for you to follow along with on a TV.

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Vera might ask you to hold onto the back of a chair and lift your right leg to the side, for example. If she detects that your left leg is moving forward during the exercise, she'll tell you to keep it in place.

"Just because the clinician gives you a sheet saying, 'OK, do these five exercises twice a day,' it doesn't mean that it gets done," said Sudipto Sur, chief technology officer of Reflexion. By comparison, he said, a system that can remind patients about exercises, and help them actually do them, tends to have them do it more.

Vera's just the latest example of how the tech that's infiltrated our daily lives is finally finding its way into medicine as well. And that's pretty noteworthy considering many doctors still carry 1990s-era pagers on their belts and in their purses when they're on call at their hospitals.

In this case, motion capture technology is finding its way into medicine at a time when it's booming in mainstream technology. It's been used for years by Hollywood moviemakers to track an actor's movements with a camera and computer. Video game makers have also used this technology to help count your score in titles like Ubisoft's Just Dance.

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In the past year or so, tech companies have witnessed motion tracking take off in connection with both virtual reality, in which you're tricked into thinking you're in a computer-generated environment, and augmented reality, in which computer-generated images get overlaid on the real world. Facebook and Microsoft, for instance, are using the technology to help make their Oculus and HoloLens headsets track people's movements as they're working and playing in virtual worlds.

Now tracking technology is beginning to find its way into telemedicine, a growing field in which patients who live far from a hospital or doctor can communicate with physicians through audio, video and data connections. A patient who's recently undergone surgery might have difficulty driving to a clinic, or may live far from medical expertise.  Telemedicine, through apps like Doctor on Demand, provides a way for them to receive care from a distance.

More than half of all US hospitals are using telemedicine in some form, according to the nonprofit American Telemedicine Association. That's thanks in part to greater availability of fast internet connections and smartphones.

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Products like Vera and the Polhemus G4, a wireless motion tracker, look like they could be the next step. Using motion capture technology to provide physical therapy in real time might even lead to quicker results.

"The patient becomes more engaged in their therapy," said Gartner analyst Mark Gilbert. "The patient is able to perform therapy at their convenience, at their own time and their own location."

The VR perspective

The promise of this tracking technology goes beyond merely following exercises you see on a TV, and then hearing a program tell you how well you did.

Marcelo Kallmann, professor of computer science at the University of California, Merced, who's been researching the best way to design these new types of programs, is also looking into virtual reality headsets. VR would give patients the sensation they're immersed in a specific three-dimensional digital environment as they watch a virtual trainer do the prescribed exercise.

Why would that be better than merely using a TV?

"The conclusion really is: it depends on the target," Kallmann said. If the goal is to train someone to hit a precise target as part of an exercise or activity, then the added depth perception in 3D might be helpful. But if the goal is to have someone watch a virtual trainer lead an exercise, then VR and 3D don't provide much benefit, he said.

The system Kallmann's team developed and tested at the UC Davis Medical Center didn't involve using a head-mounted display. Instead, images were presented on a regular PC, and Microsoft's Kinect was used for motion capture. That doesn't mean VR is totally out of the picture going forward, though.

Matt Elrod, a lead specialist at the American Physical Therapy Association, says these types of technologies can be helpful, but he worries people may become overly reliant on them.
"If somebody has a shoulder problem, just to say, 'Go do this technology' is really not the best bet," Elrod said. "What you need is a thorough evaluation, screening [and] examination to determine where the dysfunction really is."

Hadiya Green Guerrero, a senior practice specialist at APTA, said technology won't be replacing a real physical therapist anytime soon.

"Technology can definitely augment what we do as physical therapists," she said. "Those who use it know that it's not a replacement for a physical therapist."

In the meantime, you can expect to see even more tech in health. Virtual simulations are being used to train medical students and to help midwives learn how to deliver babies. Kallmann said physical therapists have been using commercial games like the Nintendo Wii Fit with their patients for quite some time, and systems like Vera are taking that technology to the next level. He expects we'll be seeing more of these types of applications.

"From the technology point of view, it's not that difficult to do," Kallmann said. "The techniques are already out there."

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