Jones Ray B, Hubble Suzanne, Taylor Lloyd, Gunn Hilary, Logan Angela, Rowland Tim, Bradwell Hannah, Connolly Luke J, Algie Kim, Anil Krithika, Halliday Bradley, Houston Sandra, Dennett Rachel, Chatfield Sarah, Buckingham Sarah, Freeman Jennifer
Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom.
School of Health Professions, University of Plymouth, Plymouth, United Kingdom.
JMIRx Med. 2021 Sep 24;2(3):e30233. doi: 10.2196/30233.
Understanding and assessing patients' body movements is essential for physical rehabilitation but is challenging in video consultations, as clinicians are frequently unable to see the whole patient or observe the patient as they perform specific movements.
The objective of this exploratory study was to assess the use of readily available technologies that would enable remote assessment of patient movement as part of a video consultation.
We reviewed the literature and available technologies and chose four technologies (Kubi and Pivo desktop robots, Facebook Portal TV, wide-angle webcam), in addition to help from a friend or a simple mobile phone holder, to assist video consultations. We used 5 standard assessments (sit-to-stand, timed "Up & Go," Berg Balance Test, ankle range of motion, shoulder range of motion) as the "challenge" for the technology. We developed an evaluation framework of 6 items: efficacy, cost, delivery, patient setup, clinician training and guidance, and safety. The coauthors, including 10 physiotherapists, then took the roles of clinician and patient to explore 7 combinations of 5 technologies. Subsequently, we applied our findings to hypothetical patients based on the researchers' family members and clinical experience.
Kubi, which allowed the clinician to remotely control the patient's device, was useful for repositioning the tablet camera to gain a better view of the patient's body parts but not for tracking movement. Facebook Portal TV was useful, but only for upper body movement, as it functions based on face tracking. Both Pivo, with automated full body tracking using a mobile phone, and the wide-angle webcam for a laptop or desktop computer show promise. Simple solutions such as having a friend operate a mobile phone and use of a mobile phone holder also have potential. The setup of these technologies will require better instructions than are currently available from suppliers, and successful use will depend on the technology readiness of patients and, to some degree, of clinicians.
Technologies that may enable clinicians to assess movement remotely as part of video consultations depend on the interplay of technology readiness, the patient's clinical conditions, and social support. The most promising off-the-shelf approaches seem to be use of wide-angle webcams, Pivo, help from a friend, or a simple mobile phone holder. Collaborative work between patients and clinicians is needed to develop and trial technological solutions to support video consultations assessing movement.
理解和评估患者的身体运动对于物理康复至关重要，但在视频会诊中却具有挑战性，因为临床医生常常无法看到患者的全貌，也无法在患者进行特定动作时对其进行观察。
这项探索性研究的目的是评估使用现成技术对患者运动进行远程评估，作为视频会诊的一部分。
我们查阅了文献和现有技术，除了借助朋友或简单的手机支架外，还选择了四种技术（Kubi和Pivo桌面机器人、Facebook Portal TV、广角网络摄像头）来辅助视频会诊。我们使用5项标准评估（从坐到站、定时“起身行走”、伯格平衡测试、踝关节活动范围、肩关节活动范围）作为对这些技术的“挑战”。我们制定了一个包含6个项目的评估框架：有效性、成本、交付、患者设置、临床医生培训与指导以及安全性。包括10名物理治疗师在内的共同作者随后分别扮演临床医生和患者的角色，探索5种技术的7种组合。随后，我们根据研究人员的家庭成员和临床经验，将研究结果应用于假设的患者。
Kubi允许临床医生远程控制患者的设备，有助于重新定位平板电脑摄像头以更好地查看患者身体部位，但无法跟踪运动。Facebook Portal TV很有用，但仅适用于上半身运动，因为它基于面部跟踪功能。Pivo通过手机实现自动全身跟踪，以及用于笔记本电脑或台式电脑的广角网络摄像头都显示出了潜力。诸如让朋友操作手机和使用手机支架等简单解决方案也具有潜力。这些技术的设置需要比供应商目前提供的更好的说明，其成功使用将取决于患者以及在某种程度上临床医生的技术准备情况。
可能使临床医生能够作为视频会诊的一部分对运动进行远程评估的技术，取决于技术准备情况、患者的临床状况和社会支持之间的相互作用。最有前景的现成方法似乎是使用广角网络摄像头、Pivo、朋友的帮助或简单的手机支架。需要患者和临床医生之间的合作来开发和试验技术解决方案，以支持评估运动的视频会诊。
