Supporting Bodily Communication in Video Consultations of Physiotherapy

Supporting
Bodily Communication
in Video Consultations
of Physiotherapy
Deepti Aggarwal
Wednesday, 16 August 17

Video Consultations of Physiotherapy
van Dyk 2014; Yellowlees 2005

Bodily Communication in Physiotherapy
Argyle 2013; Heath 1986, 2002

Existing Literature
Physiotherapy
Video
Consultation
Bodily
Communication

Prior works on Video Consultations
Focus on validation & viability for
different clinical domains.
Physiotherapy
Video
Consultation
Bodily
Communication
Ekeland et al., 2010 ; van Dyk, 2014
Only audio-visual medium is
explored.

Prior works on Physiotherapy
Physiotherapy
Video
Consultation
Bodily
Communication
Technologies are mainly
designed for autonomous
home rehabilitation.
Focus is on patients’
motivation.
Lam et al., 2016; O’Hara et al., 2016; Tang et al., 2015

Prior works on Bodily Communication
Physiotherapy
Video
Consultation
Bodily
Communication
Limitation of video mediated bodily
communication is known.
Bodily communication is primal
in face-to-face consultation.
Olson & Olson, 2013; Heath 1986, 2002

Research Gap
Physiotherapy
Video
Consultation
Bodily
Communication

Main Research Question
How can interactive technologies
support physiotherapists in
understanding bodily information
during video consultations?

Research Phases
#1 Observations
#2 Prototyping
#3 Laboratory Evaluation
#4 Field Deployments

Research Phases
#2 Prototyping
#1 Observations

Study 1 - Research Question
How do physiotherapists
interpret bodily information in
current practices of video
consultations?

#1 Observations
Face-to-Face (3) Video (7)
2 physiotherapists & 5 patients with chronic pain
Prescribed exercises: tip-toes, squats

Face-to-Face Video
1. Opening
2. History taking
3. Examination
4. Diagnosis
5. Treatment
6. Closing
Byrne & Long 1976

Lower Body
Movements

#1 Limited Visual Acuity of Video Technology
Weight Distribution Range of Movement

#2 Alignment with upper torso

Focusing Camera Removes the Context

Reduced confidence in
assessment
Less effective treatment

ACM DIS 2016 (full paper)

Research Phases
#1 Observations
#2 Prototyping

How can we collect and visualize
lower body movements to support
physiotherapists in assessing
patients during video consultations?

Key aspects of lower body movements
Weight
Distribution
Range of
Movements
Foot
Orientation

How to capture?

SoPhy
SOcks for PHYsiotherapy
Socks with sensors Web interface

SoPhy socks
IMU
Pressure
Sensors
Bluetooth
Shield
Arduino
Pro Mini

SoPhy web-interface

Research Phases
#1 Observations
#2 Prototyping

What is the diagnostic efficacy
of SoPhy for assessing lower
limb movements in video
consultations?

Study Setup
Clinician’s room
10 physiotherapists & 1 actor (patient)
Patient’s room

Study Design (2x2)
Extreme pain Low pain
Factors: Consultation Technology & Pain Levels

Study Design (2X2)
Independent
Variables
Consultation Technology - with
SoPhy & without SoPhy
Pain Levels - extreme and low
Dependent
Variables
Weight Distribution, Range of
Movement, Foot Orientation,
Confidence, #Repetitions
Data
Collection
Interviews, Questionnaire, Video
Recording

Tasks for
Participants
Assess the patient’s exercises
Organize 4 video sessions
Report confidence in a
questionnaire

Tasks for Actor
Dorsiflexion &
Plantarflexion
1-leg tip-toes &
2-leg tip-toes
Squats

Key Findings
Fewer repetitions of exercises
were required for assessment
Increased the confidence in
assessment
Insights on weight distribution
was found invaluable

ACM CHI 2017 (full paper)

Revised SoPhy Design

Revised SoPhy Interface

How does SoPhy support
physiotherapists in assessing
and treating patients with lower
limb issues during naturally
occurring video consultations?

Study Design
1 physiotherapist, 3 patients with lower limb issues
Simulated video sessions at Royal Children’s Hospital
Hospital Room #1 Hospital Room #2

Study Design
Face-to-Face
(60 mins)
Video
Consultation
(45 - 50 mins)
Face-to-Face
follow up
(15 - 10 mins)
First session Second session
Observations: 4 face-to-face and 2 video consultations
Interviews: 10

SoPhy as an Assessment Tool

SoPhy as a Therapeutic Tool

Without SoPhy With SoPhy
(Study 4)(Study 1)
#5. Treatment
#1. Opening
#2. History Taking
#3 & 4. Examination & Diagnosis
#6. Closing

Without SoPhy
Limited incidental cues Increased incidental cues
With SoPhy
(Study 4)(Study 1)
#1. Opening
Limited small talk Opportunities for small talk

Without SoPhy
Reliance on verbal
explanation
Visualisation aided the
verbal explanation
With SoPhy
(Study 4)(Study 1)
#2. History Taking
Difficulty in observing
subtle differences in
movements
Subtle differences in
movements were
distinguishable

Without SoPhy
Lack of clarity in patient’s
condition
Better understanding of
patient’s condition
With SoPhy
(Study 4)(Study 1)
#3 & 4. Examination & Diagnosis
Cheating or tricking was
difficult to detect
Contradictory behaviors
were easy to notice

Without SoPhy
Hesitation in changing
the treatment
Confidence in changing the
treatment
With SoPhy
(Study 4)(Study 1)
#5. Treatment

Without SoPhy
Limited small talk Opportunities for small talk
With SoPhy
(Study 4)(Study 1)
#6. Closing

Key Findings
Guided more specific treatment
Increased the confidence in
assessment
Made the therapy goals intuitive
for patients

Thesis Contributions
To theory -
First conceptual
understanding of
bodily communication
in physiotherapy
To clinical practice -
First exploration on
how to enhance
diagnostic ability of
clinicians over video
To methodology -
The study design of
Study 3 & 4 could
guide future
interventions
To HCI practice -
Practical insights on
the design of wearable
system around bodily
communication

Dissertation Status
Time Tasks
July - Aug.
2017
Literature Review (Ch 2)
Discussion (Ch 8)
Methodology (Ch 3)
Sept. 2017
Revision of complete thesis
Thesis Submission

Some memorable moments

OzCHI 2015
OzCHI 2015
CHI 2017

Foundation of ‘Social’NUI, 2015

Past CHI Chair :D

Space for the
convocation
photograph :)
A long awaited
award!

Thank you!

Supporting Bodily Communication in Video Consultations of Physiotherapy

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Supporting Bodily Communication in Video Consultations of Physiotherapy