Physical therapy is approaching a crisis, according to Dr. Kourosh Parsapour, founder and CEO of 5plus, a startup working on building digital health physical therapy tools. The specialty is experiencing provider shortages at the same time as the need for physical therapy and rehabilitation services increases -- as the baby boomer generation ages.
"By 2030, the number of states with substandard physical therapy will increase from 12 to 48 states, and 1 out of 5 americans will be 65 or older," said Parsapour during a panel discussion at the American Telemedicine Association event in Austin, Texas last week. "Last year, CMS reduced reimbursment to therapists by 12 percent."
Telerehabilitation, where physical therapists work with one or more patients over video chat, is one technological solution for addressing that gap. Healthbox Boston startup Theravid, for instance, is working on an online portal which includes video instructions on different exercises, online workout reminders, workout tracking, and a secure messaging system to contact their therapist. TeleRehab Systems, a stealth-mode stroke rehabilitation startup, is developing a tablet-based system.
The technology that's jumpstarting most telerehabilition startups, however, is Microsoft Kinect for Windows, an off-the-shelf 3D motion-capture sensor with an open API. Therapy games can interact directly with patients and even track their movements to report to doctors remotely. These interactions can be either realtime or asynchronous. A number of startups, many of which are coming through high-profile digital health accelerators, are leveraging those possibilities with soon-to-be released offerings.
Here are nine companies tackling digital rehab solutions, many of which Parsapour mentioned in his ATA talk or in an interview MobiHealthNews after the event.
Reflexion spun off from the West Health Institute last year and has recently begun running clinical trials to validate the technology. The company offers a rehabilitation measurement tool,which uses Microsoft Kinect software to both instruct the patient on exercises through animations and measure whether or not they're doing their exercises correctly. Physical therapists can prescribe exercises that are preloaded into the platform or design their own.
Home Team Therapy is another company bringing physical therapy to the home with interactive video. The Rock Health Boston startup calls itself a video game for physical therapy, and advertises that, as CEO Tim Fu says in a video on their website, "We're with you for the six days out of the weeks you're not seeing your physical therapist." Their offering is a combination of Microsoft Kinect software and online pre-recorded video instructions. The company is currently in closed beta.
Another company that uses the Kinect, Jintronix is offers providers specially designed, clinically tested video games that both allow patients to exercise and collect data about their exercises to send to an online portal. On the portal, physicians can make changes to the difficulty and range of motion in the games as well as preparing for their patients' next visit with the information about their movement that Microsoft Kinect tracked. Jintronix is also in closed beta.
A Romanian company enrolled in Healthbox's London class, MIRA is similar to the other startups in the space that use Microsoft Kinect to create prescribable therapy games. But Mira claims to offer a more complete software package on the provider side, including a diagnostics application that measures angles and distances on the patient's body and a patient management application to keep track of different patients. The video demo above shows what the technology looked like as of February 2012.
MotionCare360 is a web-based telerehabilitation platform that uses the Kinect for Windows camera. The company quietly launched its Software as a Service offering, which has an open API, earlier this month. The company's MC360 online platform, which features therapeutic training and assessment games for upper body rehabilitation, can be licensed for $99 per month, according to the company's website. MotionCare360 went through the MassChallenge accelerator and applied for the Dublin-based HealthXL accelerator.
Respondesign has been designing fitness games since 2004 for platforms like the Nintendo Wii, including peripheral motion capture cameras. They collaborated with software designer UbiSoft to create direct-to-consumer fitness games Yourself Fitness and My Fitness Coach. In 2010 the company released a 3D Motion tracking fitness app called MayaFit (seen in the video above). All of their offerings use a virtual avatar fitness coach character named Maya.
Although the company has plenty of experience applying motion capture cameras to fitness, their first physical therapy software is being developed for the Microsoft Kinect platform in partnership with Genesis Rehab Services.
5plus Therapy
Parsapour's own company 5plus Therapy is hoping to work with any of the above companies to establish a better standard of measurement for telerehabilitation. His software uses Microsoft Kinect to measure patients' range of movement, something that previously had to be done with a dedicated analogue physical therapy device called a goniometer.
"We're making a technologic leap that would be comparable to going from an abacus to a calculator," he told MobiHealthNews. "We're taking a tool that's necessary and we're making it digital. We're making it something that addresses the needs of a therapist in 2013."
