Microsoft Kinect and its use with rehabilitation motor therapy in the home
Since its deployment in November 2010, Microsoft’s Kinect technology has been investigated for its potential therapeutic use in motor skill rehabilitation. Kinect’s motion tracking is sufficiently accurate for the task of gauging movements during rehabilitative exercise.
A breakthrough benefit for motor rehabilitation therapy is the technology’s ease of use in the home environment.
Studies indicate monitoring accuracy at 98.26 per cent (measured on 15 individuals over 1050 psychomotor movements, with 98.26 per cent correct realisations of the exercises by the technology). This means Kinect’s tracking ability is comparable to larger, more costly specialist systems that track motion for rehabilitation purposes, at a fraction of their price.
The technology allows for connection to a personal computer and calibration to 32-bit resolution, meaning it is fine enough to detect facial feature movement if required. The system uses C++ programming and is able integrate with add on applications, and customised programs for various therapeutic uses.
There are many studies on the benefits of using Kinect technology to rehabilitate patients by tracking and measuring motor skill movement with the potential for use in the home. Benefits include the technology’s low cost, ease of access as an off the shelf product, and low social stigma associated with its use, due to its popularity for games.
Kinect’s compatibility with applications written for specialists, which enable them to write their own tailored therapy programs, gauge responses and monitor and measure progress, and its potential for social application for support groups and group games which can be played remotely, make Kinect an attractive product for rehabilitation in the home.
However, the technology is still young and long-term studies are yet to be conducted or concluded. Most studies to date are small and discrete trials in clinical environments, such as clinics, hospitals, aged care facilities and schools. A larger number of patients are yet to be studied in their homes in order to gain a realistic perspective of the effects of the use of the device in the home environment.
Factors such as limited exposure to technology and social isolation can negatively influence the rehabilitation experience by using in home technology as opposed to real group interaction. There are groups of patients who this technology will not benefit, but rather be detrimental.
This paper reviews and critiques some of the literature from scholarly articles and industry magazines and journals, specifically regarding the areas of cost, the ability to access data remotely and ease of access to the device for patients, given its ability to be used in the home for rehabilitation.
It also serves to highlight gaps in research and outline some areas where further study is required. Literature reviewed on Kinect technology has been published within the past five years, to ensure relevance to current trends.
Research supports the use of the Kinect device as having benefits such as low cost to patients who may be already experiencing high costs from consultations and equipment during therapy and, at the same time, perhaps not earning an income. This is a major benefit of the product for consumers and therapists.
Remote access to data
Being accessible remotely saves patients (sometimes) expensive travel costs to see specialists. Kinect avails remote therapy, delivery of individualised and group exercises and instructions, monitoring and gauging movements and recording and reporting on progress. It also has the potential to provide remote appointments with specialists.
Under Medicare, laws prevent remote appointment administration unless the appointment is inaccessible in any other manner (e.g. terminal illness), thereby limiting Kinect’s full potential as a consultation medium.
There is a need for significant research into the benefits of remote access to specialists and potential reform to the healthcare system due to the positive effect the availability of more remote consultation types would have on the cost of healthcare. As our ageing population become less mobile and our overall population grows, demand for medical services is expected to increase while access to specialists decreases.
Kinect is small and portable. The technology can be easily installed and used in the home environment, technical support is good and customisable reporting features can be built in for specialists. Applications are continually being developed to enable non-programming specialists (therapists) to maintain exercise schedules and change rehabilitation programs as required.
Being remotely accessible means specialist consulting fees could be pooled if there were online, group therapy sessions available. Group sessions and games are a positive reinforcer of motivation in rehabilitative therapy.
More research needs to be done to identify candidates who fit the use of home-based rehabilitation and establish a criteria for which patients will not benefit from its use. For example, patients who are unfamiliar with technology may become too frustrated to engage with the device in a positive manner.
Some patients may become further isolated using home-based rehabilitation. Real, social interaction provided by group interactions (such as support groups outside the home) could be more beneficial than pseudo gatherings provided virtually, especially if patients are already isolated from work colleges, family and friends during rehabilitation.
It is known that physical human interaction is good for mental health. Mental health affects recovery and isolation can lead to depression, an inhibitor to motivation towards rehabilitating.
Ease of use in the home
Another benefit of having the games accessible in the home is the potential for an increase in regular exercise due to ease of access, as well as independence and integration into the home and family, promoting a positive attitude to using the system.
Adversely, there is the potential to over-exercise and cause damage as well, especially given patients are not necessarily monitored in every session by a specialist. More research and development is required into the delivery of built-in safeguards and the ability for specialists to customise and individually assign limits for patients in the software, when exercise is being over- or under-used, and the development of alerts to specialists for over- or under-use.
Kinect technology provides a very promising tool for motor rehabilitation in the home. It is portable, easily set up and maintained, and accurately monitors and reports on motor movement remotely. Giving remote access to specialists has the potential to significantly reduce costs and increase independence for users and the healthcare system overall.
However, more research into areas where implementing in-home rehabilitation technology may be detrimental to rehabilitation is needed. As the technology is young, long-term results are yet to be published.
Research encompassing greater numbers of participants using technology in their homes is, to date, lacking. Most studies reviewed had fewer than 100 participants, and most were in school, clinical, aged care or therapist office environments.
Research into categorising individuals who may be adversely affected by using in-home rehabilitation technology is also required to ensure rehabilitative strategies are being delivered in a way that positively influences patients’ recovery.
References are available on request.
Posted in Australian eHealth