Restrictions imposed by the COVID-19 global pandemic have continued to alter the delivery of, and access to,
healthcare across the nation. The resulting unmet health needs have had a disproportionate effect among older
Americans as they continue to be at the highest mortality risk for the latest variants of COVID-19. Additional
health disparities due to race, gender, residential location, and income have been exacerbated by COVID-19,
further limiting equitable access to healthcare across the lifespan. These and other challenges have hastened the
shift to other modes of healthcare such as telehealth. Yet, while Zoom and other apps have facilitated remote
patient-clinician videoconferencing as the most common forms of telehealth, they do little to provide direct
physical examination needed for evaluating musculoskeletal (MSK) deficits, planning therapeutic interventions,
or guiding exercise compliance—essential components of evidence-based practice among rehabilitation
practitioners. This is especially true for obtaining measures of joint mobility, alignment, posture, balance,
strength, and function from osteoarthritis (OA) disorders; cornerstones for planning therapeutic interventions
and guiding exercise compliance. Our team of biomechanists and computer vision engineers will continue our
Phase I partnership with orthopedic and geriatric rehabilitation specialists at Massachusetts General Hospital
(MGH) to advance the development of an augmented reality (AR) platform that enables clinicians to visualize
key rehabilitative outcome measures to augment remote telehealth interactions during a video conference with
their patient. Our Phase I work demonstrated the proof-of-concept that standard 3D-cameras available in
common consumer devices (e.g., smartphones and tablets/PCs) when coupled with post-processing body
tracking algorithms can deliver accurate rehabilitation outcome measures from patients with knee OA during a
simulated telehealth visit. In Phase II we will expand our 3D body tracking algorithms and AR Platform
architecture to support a broader set of assessment protocols that accommodate a diverse array of human and
home environment factors (Aim 1); enable real-time cross-platform deployment for HIPAA-compliant
communication and presentation of outcomes on a clinician’s screen (Aim 2); and validate the prototype during
sessions involving clinic-based physical therapist and a person with knee OA remotely located in their home
across urban, suburban, and rural locations (Aim 3). Stakeholders will complete self-report questionnaires for
usability, acceptance, and perceived value followed by brief guided interviews and focus group evaluations.
Our milestone is a clinically viable and operationally effective prototype AR Telehealth Platform that is
favorably rated by clinicians and patients for use in the home. The long-term impact will expand access to
rehabilitation specialists using telehealth tools that provide evidence-based evaluations of musculoskeletal
deficits needed for guiding therapeutic interventions among at-risk segments of the population.