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Musculoskeletal conditions and injuries—including carpal tunnel syndrome and tennis elbow—affect more than half of Americans aged 18 and over, and nearly three out of four aged 65 and over. As our modern lifestyles continue to become increasingly sedentary, we can expect these numbers to rise, as sitting in front of a computer all day can lead to tendonitis, repetitive strain injury, lower back pain, and other conditions.
Many of those who suffer from chronic pain and injuries turn to a physical therapist for treatment and relief. According to a position paper issued by the American Physical Therapy Association, “As essential members of the health care team, physical therapists play an important role in the prevention and management of pain; chronic diseases and conditions such as diabetes, stroke, long Covid, and obesity; and their impact on an individual’s quality of life and ability to work in his or her community.”
Unfortunately, the United States is facing a national shortage of physical therapists. According to data from the Federation of State Boards of Physical Therapy, there were 312,716 licensed physical therapists and 127,750 licensed physical therapist assistants in the United States as of 2019. Estimates show that, due to growing demand, the country will need an additional 27,000 physical therapists by 2025. The lack of clinicians in rural communities is so acute that several senators have introduced a bipartisan bill that would make physical therapists eligible to participate in the National Health Service Corps, a student-loan repayment initiative that incentivizes medical professionals to practice in underserved areas of the country.
The good news is that physical therapists can make use of recent technological advances to help them provide care to their ever-growing patient pool. These include wearable sensors that measure, track, and provide feedback on clients’ rehab exercises. Patients can use these technologies both in the clinic, and at home, with feedback being shared directly to their clinician.
These innovations are especially helpful because—after assessing their current musculoskeletal status through a series of joint mobility measurements and tests—physical therapists typically send clients home with a series of exercises designed to reinforce healthy movement patterns. The therapist will demonstrate these rehabilitation exercises at the clinic, but the onus is then on the patient to complete them at home.
Even with a printout or set of videos demonstrating the exercises, however, clients can find it difficult to perform the exercises properly without in-person guidance from their therapist. Some find the exercises repetitive and boring, or even painful, which can cause them to skip sessions. It has been reported that approximately 20% of physical therapy patients drop out of treatment within the first three visits, with 70% failing to complete their full course of care. There are various reasons for this attrition—including the cost of treatment and the fact that patients often find it difficult to measure their progress and visualize where they are on the path to recovery —but a lack of out-of-clinic support is certainly a part of it.
In years past, attempts to fill this gap using technology have failed to adequately address the issue. For one thing, the tracking sensors available were not sufficiently advanced to provide accurate data for physical therapy applications, nor was telecommunications technology capable of making secure telehealth appointments a reality. The marketplace was arguably not ready, either. In those days, before the Fitbit became ubiquitous, consumers were not yet familiar with the use of wearables for tracking health-related data.
Now, however, the use of wearable fitness trackers, heart-health sensors, and sleep trackers has been widely adopted, and the stage is set for further innovation. Moreover, the Covid-19 pandemic has rapidly accelerated the advancement and implementation of digital healthcare.
New advances in sensing technology are set to spur further innovation in the physical-therapy field, and help fill the gap in guidance that exists in between in-clinic sessions. In recent years, for example, physical therapists have had access to new wearable tracking systems that enable them to measure and assess joint mobility more efficiently in addition to helping guide and motivate patients through their rehabilitation exercises.
Clients take the sensors home to track and measure the quality of exercises completed and get instant feedback about their progress. The tracking system can tell them if they are doing the exercises correctly and let them see tangible results as their “scores” improve. The latest tech increases client engagement in rehab programs even more by gamifying the process. With this added level of motivation, clients have extra incentive to complete their rehab exercises and stick with their treatment program.
As this technology advances, these devices will get increasingly sophisticated, providing therapists with even more nuanced and accurate insights that are both actionable and relevant to their established clinical workflow. From the patient perspective, any new systems that emerge will need to provide sufficient feedback on how well they are completing their rehab exercises and help them monitor their progress but above all, they will need to be engaging.
The goal, after all, is to make it easier for patients to complete their entire course of care, including the parts that they have to do outside the clinic. Research has shown that patients who remain in therapy are more likely to recover from injuries and find relief from pain and other chronic conditions. By embracing the latest technology, clinicians can help their patients stay on track—not just to achieve their therapy goals, but also to live healthier, more fulfilling lives.
Photo: mrspopman, Getty Images