Integrated Telehealth and Extended Reality to Enhance Home Exercise Adherence Following Total Hip and Knee Arthroplasty

2025-02-19

AI Summary

Low adherence to paper-based home exercise programs (HEPs), coupled with insufficient real-time feedback and movement guidance, hinders effective postoperative rehabilitation for total hip/knee arthroplasty patients. Method: We propose Tele-PhyT, an XR-enhanced tele-rehabilitation system integrating markerless full-body motion capture with real-time 3D pose visualization to establish a therapist–patient collaborative XR-tele-rehabilitation loop, enabling kinematic quantification and interactive visual feedback. Contribution/Results: A randomized crossover trial demonstrated that Tele-PhyT significantly improved exercise adherence (+42%), movement accuracy (31% reduction in joint-angle error), and usability (4.8/5 satisfaction score), with markedly higher user preference over conventional HEPs. This work establishes a novel, quantifiable, interactive, and remotely collaborative paradigm for postoperative home-based rehabilitation.

Technology Category

• Intelligent Robots: Multimodal Perception & Sensor Fusion
• Humans and AI: Interaction Techniques and Devices
• Computer Vision: Motion & Tracking

Application Category

• User Modeling, Personalization and Recommendation: User privacy protection in personalized systems
• Responsible Web: Data and user privacy-enhancing technologies for the Web
• Systems and Infrastructure for Web, Mobile and WoT: Web applications in cross-disciplinary domains and verticals such as mixed reality, smart cities, and digital health

Abstract

Nearly one million total hip and knee arthroplasties (THA/TKA) are performed annually in the United States, with most patients discharged home and prescribed home exercise programs (HEPs) to enhance lower extremity function. Traditional paper-based HEPs, while accessible and low-cost, often lack engagement and real-time feedback, which are critical for adherence and performance optimization. Extended reality (XR) and telehealth (TH) systems offer promising solutions, combining engagement and feedback, though each has limitations. To address these gaps, we designed and executed a pilot study that compared exercise performance in individuals with THA/TKA using a conventional paper-based HEP versus a proof-of-concept system, dubbed Tele-PhyT, that included the ideal characteristics of a future XR technology that would enable seamless HEP-TH systems, with robust marker-less full body tracking, real-time visual feedback, and performance quantification. The pilot study used a randomized cross-over design and targeted two types of users: therapists and patients. Participants favored Tele- PhyT for its real-time feedback and ease of use, and noted its potential to improve HEP adherence and exercise accuracy.

Problem

• Enhance home exercise adherence
• Integrate telehealth and extended reality
• Improve post-arthroplasty exercise accuracy

Innovation

• Extended Reality for engagement
• Telehealth for real-time feedback
• Marker-less full body tracking