Supporting bodily communication in video consultations of physiotherapy

Abstract

Physiotherapists are increasingly organising video consultations to support their patients over-a-distance. Physiotherapy is all about movements, and physiotherapists work on improving the subtle differences in the movements to restore the functioning of the affected body part. However, there exists a limited understanding on how physiotherapists assess and treat patient’s movements over video particularly when the limitations of video technology in mediating bodily information are already known.

This thesis attempts to fill the gap by investigating how interactive technologies can support physiotherapists in understanding the patient’s bodily information during video consultations. To address this question, I conducted three studies each employing a different methodology. Study 1 examined the challenges that physiotherapists face in interpreting patients’ bodily information during video consultations through a field study. This study highlighted that video technology limits physiotherapists in understanding subtle differences in patient’s movements particularly related to lower limbs. Findings of this study guided the development of a research prototype, SoPhy - a wearable technology that monitors lower limb movements of patients over-a-distance. SoPhy consists of two parts: (1) a pair of socks with embedded sensors that captures patient’s movements; and (2) a web-interface that displays information about weight distribution, range of movement, and foot orientation to physiotherapists in real-time. Study 2 and 3 were focused on the evaluation of the developed prototype first in the laboratory through experimental research, and then in the hospital setting through field deployments. Study 2 showed that SoPhy increased the diagnostic confidence of physiotherapists in assessing lower limb movements over video. And Study 3 showed that SoPhy enhanced the clinician-patient communication, and guided more accurate assessment and treatment of the patients during video consultations.

This thesis makes four contributions: First, it provides a detailed understanding of how bodily communication is employed by physiotherapists during video consultations. Secondly, it develops an understanding of the limitations of video technology in supporting the tasks of physiotherapists. The third contribution is a novel technology, SoPhy, that communicates information of patient’s weight distribution patterns over-a-distance to support physiotherapists in their clinical tasks. Finally, the thesis demonstrates that the efficacy of physiotherapists to assess and treat patients over video can be enhanced by using sensing technologies like SoPhy. The thesis aims to stimulate interest in designing novel technologies that can support effective assessment and treatment of body movements over-a-distance.