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Supporting
Bodily Communication
in Video Consultations of
Physiotherapy
Deepti Aggarwal
Friday, 10 March 17
Video Consultations
van Dyk 2014; Yellowlees 2005
Friday, 10 March 17
Bodily Communication
Argyle 2013; Heath 1986, 2002
Friday, 10 March 17
Bodily Communication in Physiotherapy
Friday, 10 March 17
Research Gaps
Friday, 10 March 17
Main Research Question
How can interactive technologies
support physiotherapists in
understanding bodily information
durin...
Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Research Question
How do physiotherapists
interpret bodily information in
current practices of video
consultations?
Friday...
#1 Observations
Face-to-Face (3) Video (7)
2 physiotherapists & 5 patients with chronic pain
Prescribed exercises: tip-toe...
ACM DIS 2016 (full paper)
Friday, 10 March 17
Face-to-Face Video
1. Opening
2. History taking
3. Examination
4. Diagnosis
5. Treatment
6. Closing
Byrne & Long 1976
Frid...
Face-to-Face Video
Appearance
(Full body)
Posture
Movement
(Walking)
Orientation
Appearance
(Upper Torso)
Posture
Movement...
Face-to-Face Video
Facial Expressions
(Tears, red cheeks, tensed
eyes)
Quality of
Movements
(Depth, range, smoothness)
Eye...
Face-to-Face Video
Tactile feedback
(Tightness, inflammation,
temperature)
Response to touch
(Fear, protective spasm,
faci...
Face-to-Face Video
Touch on
patient’s body
5. Treatment
Touch on own
body
Body posture
Tone of speech
(pitch)
Efforts
(fat...
Face-to-Face Video6. Closing
Body language
Facial expressions
Body language
Facial expressions
Friday, 10 March 17
Key Takeaways
Lower limb movements are
difficult to observe
Less specific treatment
Video limits a wide range
of bodily cu...
Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Key aspects of lower body movements
Weight
Distribution
Range of
Movements
Foot
Orientation
Friday, 10 March 17
Research Question
How can we collect and visualize
lower body movements to support
physiotherapists during video
consultat...
Wii-Fit board
McGough et al. 2012
Friday, 10 March 17
Sensoria socks
Sarnow et al. 1994
Friday, 10 March 17
SoPhy
SOcks for PHYsiotherapy
Socks with sensors Web interface
Friday, 10 March 17
SoPhy socks
IMU
Pressure
Sensors
Bluetooth
Shield
Arduino
Pro Mini
Friday, 10 March 17
SoPhy web-interface
Friday, 10 March 17
Friday, 10 March 17
Research Question
How does SoPhy help
physiotherapists in assessing
lower body movements during
video consultations?
Frida...
#2 Lab study
Clinician’s room
10 physiotherapists & 1 actor (patient)
Patient’s room
Friday, 10 March 17
Study Design (2x2)
Extreme pain Low pain
Friday, 10 March 17
Tasks for
Participants
Assess the patient’s exercises
Organize 4 video sessions
Report confidence in a
questionnaire
Frida...
Tasks for Actor
Dorsiflexion &
Plantarflexion
1-leg tip-toes &
2-leg tip-toes
Squats
Friday, 10 March 17
Increase in Confidence
Without SoPhy, I may not be able to pick up
things just from video. Like I thought, ‘Ooh!
that foot...
Fewer Repetitions of Exercises
Exercises with SoPhy
without
SoPhy
Dorsiflexion
F(1,36) = 6.99, p<.05
M = 8.10,
SD = 3.21
M...
Fewer Repetitions of Exercises
Over video, I can see the person only from
one direction. [...] The sock system provides
me...
Deeper Insights on Weight Distribution
It’s always challenging to understand weight
bearing because the pressure points ar...
Challenges
Interference to visual
observation
Alignment with clinical practice
Friday, 10 March 17
ACM CHI 2017 (full paper)
Friday, 10 March 17
Limitations
Controlled lab study
Focus on assessment
Friday, 10 March 17
Research Phases
#1 Observations
#2 Designing & Lab study
#3 Field Deployments
Friday, 10 March 17
Research Question
How does SoPhy support
physiotherapists in assessing
and treating patients, with lower
limb issues, duri...
Revised SoPhy socks
Use of bright colored socks to support visual observations
Friday, 10 March 17
Revised SoPhy web-interface
To align with clinical practice
Friday, 10 March 17
Study Design
2 physiotherapists & 5-7 patients with lower limb issues
Simulated video sessions at Royal Children’s Hospita...
Study Design
Face-to-Face
(60 mins)
Video
Consultation
(45 - 50 mins)
Face-to-Face
follow up
(15 - 10 mins)
First session ...
Study Setup
Friday, 10 March 17
Session in Action
Friday, 10 March 17
Video without SoPhy
(study 1)
1. Opening
2. History taking
3. Examination
4. Diagnosis
5. Treatment
6. Closing
Video with ...
Study 1
Video with
SoPhy
Appearance
(Upper Torso)
Posture
(Upper Torso)
Movement
(sitting)
Orientation
Appearance
(Upper T...
Thesis Contributions
Conceptual understanding of bodily communication
in video consultations of physiotherapy
Designed and...
Dissertation Status
Commenced study 3
Finished study 1, 2
Thesis Chapters 4 & 6 - first
draft finished
Friday, 10 March 17
Completion Plan
Time Tasks
March - April
2017
Continue study 3
Finish Chapters 2, 3 & 5
Revise Chapters 2 to 6
May - June
...
Thank you
Friday, 10 March 17
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Supporting Bodily Communication in Video Consultations of Physiotherapy

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This is my 3rd year review seminar. I presented an overview of the two studies I have conducted so far.

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Supporting Bodily Communication in Video Consultations of Physiotherapy

  1. 1. Supporting Bodily Communication in Video Consultations of Physiotherapy Deepti Aggarwal Friday, 10 March 17
  2. 2. Video Consultations van Dyk 2014; Yellowlees 2005 Friday, 10 March 17
  3. 3. Bodily Communication Argyle 2013; Heath 1986, 2002 Friday, 10 March 17
  4. 4. Bodily Communication in Physiotherapy Friday, 10 March 17
  5. 5. Research Gaps Friday, 10 March 17
  6. 6. Main Research Question How can interactive technologies support physiotherapists in understanding bodily information during video consultations? Friday, 10 March 17
  7. 7. Research Phases #1 Observations #2 Designing & Lab study #3 Field Deployments Friday, 10 March 17
  8. 8. Research Phases #1 Observations #2 Designing & Lab study #3 Field Deployments Friday, 10 March 17
  9. 9. Research Question How do physiotherapists interpret bodily information in current practices of video consultations? Friday, 10 March 17
  10. 10. #1 Observations Face-to-Face (3) Video (7) 2 physiotherapists & 5 patients with chronic pain Prescribed exercises: tip-toes, squats Friday, 10 March 17
  11. 11. ACM DIS 2016 (full paper) Friday, 10 March 17
  12. 12. Face-to-Face Video 1. Opening 2. History taking 3. Examination 4. Diagnosis 5. Treatment 6. Closing Byrne & Long 1976 Friday, 10 March 17
  13. 13. Face-to-Face Video Appearance (Full body) Posture Movement (Walking) Orientation Appearance (Upper Torso) Posture Movement Orientation 1. Opening Friday, 10 March 17
  14. 14. Face-to-Face Video Facial Expressions (Tears, red cheeks, tensed eyes) Quality of Movements (Depth, range, smoothness) Eye Contacts (for encouragement, willingness to engage) 2. History Taking Eye Contacts (encouragement, willingness to engage) Quality of Movements (depth, range, smoothness) Facial Expressions (Tears, red cheeks, tensed eyes) Friday, 10 March 17
  15. 15. Face-to-Face Video Tactile feedback (Tightness, inflammation, temperature) Response to touch (Fear, protective spasm, facial expression) Touch on patient’s body 3 & 4. Examination & Diagnosis Response to touch (Fear, protective spasm, facial expression) Tactile feedback (Tightness, inflammation, temperature) Touch on own body Friday, 10 March 17
  16. 16. Face-to-Face Video Touch on patient’s body 5. Treatment Touch on own body Body posture Tone of speech (pitch) Efforts (fatigue, tremor) Body posture Tone of speech (pitch) Efforts (fatigue, tremor) Friday, 10 March 17
  17. 17. Face-to-Face Video6. Closing Body language Facial expressions Body language Facial expressions Friday, 10 March 17
  18. 18. Key Takeaways Lower limb movements are difficult to observe Less specific treatment Video limits a wide range of bodily cues Friday, 10 March 17
  19. 19. Research Phases #1 Observations #2 Designing & Lab study #3 Field Deployments Friday, 10 March 17
  20. 20. Key aspects of lower body movements Weight Distribution Range of Movements Foot Orientation Friday, 10 March 17
  21. 21. Research Question How can we collect and visualize lower body movements to support physiotherapists during video consultations? Friday, 10 March 17
  22. 22. Wii-Fit board McGough et al. 2012 Friday, 10 March 17
  23. 23. Sensoria socks Sarnow et al. 1994 Friday, 10 March 17
  24. 24. SoPhy SOcks for PHYsiotherapy Socks with sensors Web interface Friday, 10 March 17
  25. 25. SoPhy socks IMU Pressure Sensors Bluetooth Shield Arduino Pro Mini Friday, 10 March 17
  26. 26. SoPhy web-interface Friday, 10 March 17
  27. 27. Friday, 10 March 17
  28. 28. Research Question How does SoPhy help physiotherapists in assessing lower body movements during video consultations? Friday, 10 March 17
  29. 29. #2 Lab study Clinician’s room 10 physiotherapists & 1 actor (patient) Patient’s room Friday, 10 March 17
  30. 30. Study Design (2x2) Extreme pain Low pain Friday, 10 March 17
  31. 31. Tasks for Participants Assess the patient’s exercises Organize 4 video sessions Report confidence in a questionnaire Friday, 10 March 17
  32. 32. Tasks for Actor Dorsiflexion & Plantarflexion 1-leg tip-toes & 2-leg tip-toes Squats Friday, 10 March 17
  33. 33. Increase in Confidence Without SoPhy, I may not be able to pick up things just from video. Like I thought, ‘Ooh! that foot looks tilted outside’, but then whether it has any relation with their weight distribution or not, I can’t tell just from the video. (P2) Exercises with SoPhy without SoPhy Squats F(1,36) = 10.97, p<.01 M = 5.75, SD = 1.06 M = 4.17, SD = 1.13 Friday, 10 March 17
  34. 34. Fewer Repetitions of Exercises Exercises with SoPhy without SoPhy Dorsiflexion F(1,36) = 6.99, p<.05 M = 8.10, SD = 3.21 M = 11.25, SD = 4.54 Plantarflexion F(1,36) = 6.14, p<.05 M = 7.45, SD = 3.88 M = 10.60, SD = 4.24 Squats F(1,36) = 8.36, p<.01 M = 6.05, SD = 2.48 M = 8.05, SD = 3.18 Friday, 10 March 17
  35. 35. Fewer Repetitions of Exercises Over video, I can see the person only from one direction. [...] The sock system provides me this detailed information irrespective of how the person is standing or sitting. I did not ask the patient to turn backwards or sideways when I had the sock data - the system was already doing it for me. (P3) Friday, 10 March 17
  36. 36. Deeper Insights on Weight Distribution It’s always challenging to understand weight bearing because the pressure points are not visible. It’s easy in cases when the person is putting more weight on one foot than other. But it is difficult to understand how the pressure is distributed across the foot, is it on the heels, or on the balls. (P8) Friday, 10 March 17
  37. 37. Challenges Interference to visual observation Alignment with clinical practice Friday, 10 March 17
  38. 38. ACM CHI 2017 (full paper) Friday, 10 March 17
  39. 39. Limitations Controlled lab study Focus on assessment Friday, 10 March 17
  40. 40. Research Phases #1 Observations #2 Designing & Lab study #3 Field Deployments Friday, 10 March 17
  41. 41. Research Question How does SoPhy support physiotherapists in assessing and treating patients, with lower limb issues, during naturally occurring video consultations? Friday, 10 March 17
  42. 42. Revised SoPhy socks Use of bright colored socks to support visual observations Friday, 10 March 17
  43. 43. Revised SoPhy web-interface To align with clinical practice Friday, 10 March 17
  44. 44. Study Design 2 physiotherapists & 5-7 patients with lower limb issues Simulated video sessions at Royal Children’s Hospital Hospital Room #1 Hospital Room #2 Friday, 10 March 17
  45. 45. Study Design Face-to-Face (60 mins) Video Consultation (45 - 50 mins) Face-to-Face follow up (15 - 10 mins) First session Second session Participant Observations & Interviews Friday, 10 March 17
  46. 46. Study Setup Friday, 10 March 17
  47. 47. Session in Action Friday, 10 March 17
  48. 48. Video without SoPhy (study 1) 1. Opening 2. History taking 3. Examination 4. Diagnosis 5. Treatment 6. Closing Video with SoPhy (study 3) Friday, 10 March 17
  49. 49. Study 1 Video with SoPhy Appearance (Upper Torso) Posture (Upper Torso) Movement (sitting) Orientation Appearance (Upper Torso) Posture (upper torso + feet) Movement (walking, sitting) Orientation 1. Opening Friday, 10 March 17
  50. 50. Thesis Contributions Conceptual understanding of bodily communication in video consultations of physiotherapy Designed and studied a technology to support physiotherapists during video consultations Friday, 10 March 17
  51. 51. Dissertation Status Commenced study 3 Finished study 1, 2 Thesis Chapters 4 & 6 - first draft finished Friday, 10 March 17
  52. 52. Completion Plan Time Tasks March - April 2017 Continue study 3 Finish Chapters 2, 3 & 5 Revise Chapters 2 to 6 May - June 2017 Attend CHI 2017 Finish Study 3 Finish Chapters 7, 8, 9 July - August 2017 Finish Chapter 1 Revise complete thesis Thesis Submission Friday, 10 March 17
  53. 53. Thank you Friday, 10 March 17

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