Wearables Enable Remote Physical Therapy

A new cloud-based platform utilizes wearable sensors to enable a patient to do physical therapy at home while a physical therapist remotely monitors their progress.

by John Kosowatz
June 27, 2017

Virgilio Bento is developing a mobile platform for patients who require physical therapy that promises convenience while reducing health care costs. The idea holds promise, especially as the number of aging Baby Boomers grows along with the need for increased health care. But the idea was planted by a family crisis that required Bento’s parents, who are Portuguese, to travel to Cuba where his critically injured brother could access affordable physical therapy.

Bento went on to earn a Ph.D. in electrical engineering, never forgetting the experience and determined to find an alternative solution for how accident and stroke victims recover. The result is the "Stroke Wearable Operative Rehabilitation Device" (SWORD). The web-based platform utilizes wearable sensors, artificial intelligence, and proprietary software to enable a patient to do physical therapy at home while a physical therapist remotely monitors their progress. Industry executives believe it has the potential to reduce costs and stretch the ability of a limited number of physical therapists to work with more patients.

“Physical therapy is the hardest position to fill in the US,” says Tom Paprocki, managing director of Direct Supply’s innovation and technology center. The firm is the largest supplier of equipment and services to senior homes in the US, and will distribute SWORD to the market. “There’s an increasing number of seniors and not enough physical therapists to deliver services. The math just doesn’t work.”

Enter SWORD. “Our vision is for every patient that requires physical therapy to have access to it in their home,” says Bento.

Taking advantage of the increasing development of sensors to capture in detail a person’s range of physical motion, along with artificial intelligence and laptop computing, Bento developed a digital program for physical therapy that is starting to be rolled out in the US. It has been successfully piloted in Europe, after receiving development funding from the European Union. More than 1,000 patients are now using the device, he says.

“The program analyzes the motion of the patient, and from that analysis, it directs the patient” on how better to perform the exercise, or praise the patient for doing it correctly, says Bento. “It provides treatment when the physical therapist is not there.”

Bento says the technology will not replace physical therapists, but will be key to leveraging their ability to handle what is expected to be an increased workload. “It is scaling their reach. Now, a patient has to go to a clinical center. You can wait up to two months for a visit. In our vision, this is the next 50 years in health care: A control center to remotely evaluate patients. It is a new paradigm.”

“From a rehab perspective, we’re looking for ways to improve clinical actions,” says Sarah Thomas, with Genesis Rehabilitation Services. Thomas worked with Bento as part of a year-long mentorship program the firm has with promising startups. “There is a shift coming in US healthcare, from value-based service to results-based. SWORD allows remote access and patient engagement.”

Paprocki and Thomas note that therapists now do not have feedback from patients performing “homework” exercises prescribed to be done at home between office visits. They can surmise progress during office visits, but there’s always a risk that people may not be engaged in home exercise, or perform the exercise correctly.

“People should be more engaged and we’re trying to change behavior,” says Thomas. “So there is biofeedback in the platform and an incentive to continue.”

SWORD gives immediate feedback to the patient on how the exercises are performed, scoring the number of correct and incorrect movements. Medals are given for correct movements, making it a game.

“A physical therapist now has no way of knowing what you did at home,” says Paprocki. “With SWORD, they know everything.

Bento finished the first prototype of the platform in 2011, for his Ph.D in electrical engineering. He says it has evolved through size, cost, and efficiency. “We took advantage of the boon from the smart-phone revolution,” he says. “We’ve taken advantage of some really good sensors, and we can access at a much lower cost.”

Perhaps the key to the system is SWORD’s proprietary software and motion-tracking technology, which Paprocki and Thomas say is more advanced than competitors using sensing technology adapted from gaming, such as X-Box. “We were unable to quantify [motions] with the clinical precision needed using solutions that were on the market,” says Bento.

So Bento and his team developed new algorithims and an artificial intelligence logic-based solution “that mimics feedback from a physical therapist.” In other words, motion sensors worn by the patient precisely monitor physical movement, and the program interprets how accurate the patient is in doing the exercise and providing immediate feedback to the patient. Results are relayed through the Cloud to the attending physical therapist. “It is a powerful platform,” says Bento.

Pricing is yet to be determined, and who will pay and how much are still questions that have to be answered in the US as the debate over health care insurance continues. “Health care is a fairly irrational industry,” notes Paprocki.

“SWORD is doing more with less,” he says. “Ultimately, this is where its all going.”