Nearly 1 out of 3 Canadians have sustained some form of Musculoskeletal injury. The prevalence of these injuries, which include carpal tunnel and tennis elbow among others, continues to rise due to our increasingly sedentary lifestyles, uptick of computer and cell phone usage, and growing aging population. In many cases, these individuals turn to a physiotherapist for treatment and relief.
There are more than 26,000 physiotherapists working across a range of facilities in Canada. Physiotherapists combine their expertise in body mechanics with specialized hands-on clinical skills to diagnose and treat such conditions. Hence, physiotherapists play a crucial role in helping restore and maintain good musculoskeletal health in the Canadian population.
However, demographic trends reveal a source of concern. The physiotherapy industry is under significant strain due to a shortage of physiotherapists in relation to the growing prevalence of musculoskeletal injuries and reinjuries in our population. The net result is that wait times to see a physiotherapist can be as long as several weeks to months. Furthermore, capped insurance reimbursement results in most patients having access to a limited number of short treatment sessions. All of which has been exacerbated by COVID-19, which has significantly impacted clinical capacity.
The good news is, new trends in technology are stepping in to support physiotherapists in providing care to their ever-growing patient pool. These include wearable sensors which help physiotherapists measure, track, and provide feedback on rehabilitation exercises. In addition many of these technologies can be used at home and the therapist can support the patient via “telehealth” video calls.
The first step of a physiotherapy regimen is the physiotherapist assessing the client’s current musculoskeletal status through a series of joint mobility measurements and tests. Another crucial step is the physiotherapist teaching and retraining healthy movement patterns in the client. This is typically done via a series of rehabilitation exercises which are demonstrated in-clinic; but subsequently need to be completed by the client at home. A patient’s recovery is significantly impacted by their compliance to a home exercise program.
Today, these exercises are typically sent home with the client using either printouts or a series of videos. However, often, clients are not able to correctly complete the exercises in the absence of in-person guidance from the physiotherapist. Furthermore, these exercises can be boringly repetitive and painful, causing some clients to skip their exercise session all together. In fact, approximately 20% of clients end-up dropping out of the overall treatment program, in no small part due to the lack of “out-of-clinic” support for the patient, which is a significant gap in the clinical workflow.
The physiotherapy industry has not had the tools to try and address these issues, but is now primed for exciting innovation via technology. For example, new wearable tracking systems have emerged in recent years that aim to help physiotherapists measure and assess joint mobility more efficiently as well as helping physiotherapists guide and motivate patients through their rehabilitation exercises.
These systems also fill the gap in guidance that exists in between in-clinic physiotherapy sessions. The sensors, sent home with the client, are used to track and measure the quality of rehab exercises completed and provide instantaneous feedback and progress measurement for the client. Clients know if they are doing their exercises correctly and they are able to see tangible results as their “scores” improve. Not only that, but the newest tech that’s emerging has developed gamified rehabilitation programs that increase engagement in the rehabilitation process. In this manner, physiotherapists can leverage this technology to ensure their clients have the motivation and certainty required to complete their rehab exercises and stick with their treatment program.
The concept of using sensors to augment physiotherapy care is not new. Many attempts have been made over the years to address the “out-of-clinic” gap in the workflow. However, these attempts failed to make it to the mainstream for several reasons. Firstly, the sensing technology was inadequate to provide sufficient tracking accuracy for physiotherapy applications. Secondly, the telecommunication technology was not yet developed sufficiently to make secure tele-health type communication feasible. Thirdly, insurers had not yet recognized the value that data generated from wearable sensors can have within clinical workflows. Finally, consumers were not yet familiar with the use of wearables for healthcare tracking.
The past year has completely altered how the industry operates, setting the stage for innovation. Advances in sensing technology by several promising start-ups in the field; combined with better healthcare telecommunication infrastructure accelerated by COVID-19, mean that we now have the technology required to fill this need. Furthermore, rapid proliferation and adoption of fitness trackers, heart health sensors and sleep trackers have attuned both consumers and insurers to the healthcare benefits that wearable sensors can provide.
Over the next several years, we should expect to see the rapid adoption of this technology to help physiotherapists fill demographic and “out-of-clinic” gaps in the patient journey.
To ensure rapid adoption, device manufactures should abide by the key tenants followed by all successful medical device companies. These sensor systems will need to be developed with sufficient tracking accuracy and nuance to be able to assist therapists with the complex assessments that they conduct and to provide sufficient feedback on the quality of rehab exercises. The insights delivered from these systems should be actionable and relevant to the established clinical standards and workflows. Crucially, these systems will need to be very engaging for the patient and provide an exceptional experience to both client and clinician.
The confluence of demographic and market adoption trends combined with newly available technology suggests that the next several years will be filled with new and innovative solutions within physiotherapy. A boon for both physiotherapists and the population as a whole.
Co-authored by Lukas-Karim Merhi & Gautam Sadarangani, co-founders of TENZR Health
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