supporting bodily communication in video consultations of physiotherapy
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Supporting Bodily Communication in Video Consultations of PhysiotherapyDeepti Aggarwal
Friday, 10 March 17
Video Consultationsvan Dyk 2014; Yellowlees 2005
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Bodily CommunicationArgyle 2013; Heath 1986, 2002
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Bodily Communication in Physiotherapy
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Research Gaps
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Main Research Question
How can interactive technologies support physiotherapists in
understanding bodily information during video consultations?
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Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Research Question
How do physiotherapists interpret bodily information in
current practices of video consultations?
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#1 Observations
Face-to-Face (3) Video (7)
2 physiotherapists & 5 patients with chronic pain Prescribed exercises: tip-toes, squats
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ACM DIS 2016 (full paper)
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Face-to-Face Video
1. Opening
2. History taking
3. Examination
4. Diagnosis
5. Treatment
6. Closing
Byrne & Long 1976
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Face-to-Face Video
Appearance(Full body)
Posture
Movement(Walking)
Orientation
Appearance(Upper Torso)
Posture
Movement
Orientation
1. Opening
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Face-to-Face Video
Facial Expressions(Tears, red cheeks, tensed
eyes)
Quality of Movements
(Depth, range, smoothness)
Eye Contacts(for encouragement,
willingness to engage)
2. History Taking
Eye Contacts(encouragement,
willingness to engage)
Quality of Movements
(depth, range, smoothness)
Facial Expressions(Tears, red cheeks, tensed
eyes)
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Face-to-Face Video
Tactile feedback(Tightness, inflammation,
temperature)
Response to touch(Fear, protective spasm,
facial expression)
Touch on patient’s body
3 & 4. Examination & Diagnosis
Response to touch(Fear, protective spasm,
facial expression)
Tactile feedback(Tightness, inflammation,
temperature)
Touch on own body
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Face-to-Face Video
Touch on patient’s body
5. Treatment
Touch on own body
Body posture
Tone of speech(pitch)
Efforts(fatigue, tremor)
Body posture
Tone of speech(pitch)
Efforts(fatigue, tremor)
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Face-to-Face Video6. Closing
Body language
Facial expressions
Body language
Facial expressions
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Key Takeaways
Lower limb movements are difficult to observe
Less specific treatment
Video limits a wide range of bodily cues
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Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
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Key aspects of lower body movements
Weight Distribution
Range of Movements
Foot Orientation
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Research Question
How can we collect and visualize lower body movements to support
physiotherapists during video consultations?
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Wii-Fit boardMcGough et al. 2012
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Sensoria socksSarnow et al. 1994
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SoPhy
SOcks for PHYsiotherapy
Socks with sensors Web interface
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SoPhy socks
IMU
Pressure Sensors
Bluetooth Shield
Arduino Pro Mini
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SoPhy web-interface
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Friday, 10 March 17
Research Question
How does SoPhy help physiotherapists in assessing
lower body movements during video consultations?
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#2 Lab study
Clinician’s room
10 physiotherapists & 1 actor (patient)
Patient’s room
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Study Design (2x2)
Extreme pain Low pain
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Tasks for Participants
Assess the patient’s exercises
Organize 4 video sessions
Report confidence in a questionnaire
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Tasks for Actor
Dorsiflexion & Plantarflexion
1-leg tip-toes & 2-leg tip-toes
Squats
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Increase in Confidence
Without SoPhy, I may not be able to pick up things just from video. Like I thought, ‘Ooh!
that foot looks tilted outside’, but then whether it has any relation with their weight distribution or not, I can’t tell just from the
video. (P2)
Exercises with SoPhy without SoPhy
SquatsF(1,36) = 10.97, p<.01
M = 5.75,
SD = 1.06M = 4.17,SD = 1.13
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Fewer Repetitions of Exercises
Exercises with SoPhy without SoPhy
DorsiflexionF(1,36) = 6.99, p<.05
M = 8.10,
SD = 3.21M = 11.25,SD = 4.54
PlantarflexionF(1,36) = 6.14, p<.05
M = 7.45,
SD = 3.88M = 10.60,SD = 4.24
SquatsF(1,36) = 8.36, p<.01
M = 6.05,
SD = 2.48
M = 8.05,
SD = 3.18
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Fewer Repetitions of Exercises
Over video, I can see the person only from one direction. [...] The sock system provides me this detailed information irrespective of
how the person is standing or sitting. I did not ask the patient to turn backwards or sideways
when I had the sock data - the system was already doing it for me. (P3)
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Deeper Insights on Weight Distribution
It’s always challenging to understand weight bearing because the pressure points are not visible. It’s easy in cases when the person is putting more weight on one foot than other.
But it is difficult to understand how the pressure is distributed across the foot, is it on
the heels, or on the balls. (P8)
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Challenges
Interference to visual observation
Alignment with clinical practice
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ACM CHI 2017 (full paper)
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Limitations
Controlled lab study
Focus on assessment
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Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
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Research Question
How does SoPhy support physiotherapists in assessing
and treating patients, with lower limb issues, during naturally
occurring video consultations?
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Revised SoPhy socks
Use of bright colored socks to support visual observations
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Revised SoPhy web-interface
To align with clinical practice
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Study Design
2 physiotherapists & 5-7 patients with lower limb issuesSimulated video sessions at Royal Children’s Hospital
Hospital Room #1 Hospital Room #2
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Study Design
Face-to-Face (60 mins)
Video Consultation
(45 - 50 mins)
Face-to-Face follow up (15 - 10 mins)
First session Second session
Participant Observations & Interviews
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Study Setup
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Session in Action
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Video without SoPhy (study 1)
1. Opening
2. History taking
3. Examination
4. Diagnosis
5. Treatment
6. Closing
Video with SoPhy (study 3)
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Study 1Video with
SoPhy
Appearance(Upper Torso)
Posture(Upper Torso)
Movement(sitting)
Orientation
Appearance(Upper Torso)
Posture(upper torso + feet)
Movement(walking, sitting)
Orientation
1. Opening
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Thesis Contributions
Conceptual understanding of bodily communication in video consultations of physiotherapy
Designed and studied a technology to support physiotherapists during video consultations
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Dissertation Status
Commenced study 3
Finished study 1, 2
Thesis Chapters 4 & 6 - first draft finished
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Completion Plan
Time Tasks
March - April 2017
Continue study 3Finish Chapters 2, 3 & 5Revise Chapters 2 to 6
May - June 2017
Attend CHI 2017Finish Study 3Finish Chapters 7, 8, 9
July - August 2017
Finish Chapter 1Revise complete thesisThesis Submission
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Thank you
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