H.J. Weber1, C.J. Barr1, M.E.L. van den Berg1
1Flinders University, Adelaide, Australia
Background: Active videogame and computer-based (AVC) technologies are increasingly used, in addition to usual care, to increase patient engagement in repetitive, high intensity rehabilitation programs. Little is known about how the use of AVC technologies affects the way clinical practice is delivered, including if and how it impacts therapists’ focus of visual attention.
Purpose: To assess physiotherapists’ focus of visual attention during a rehabilitation session with and without the use of AVC technologies.
Methods: In this observational study physiotherapist and patient dyads were recruited from two inpatient rehabilitation wards. Traditional physiotherapy exercises, addressing patients’ difficulties with either sit to stand, stepping, standing balance or dynamic balance, were matched with AVC assisted exercises, using the Humac Balance System (CSMi Solutions) or Intelligent Rehabilitation Solutions (Doctor Kinetic). Next, exercises in both conditions were conducted and recorded in random order whilst the physiotherapist wore eye tracking glasses (Tobii Pro Glasses 2). Eye gaze data was processed with the Tobii I-VT (Attention) filter, which identifies when the fovea of the eye is stabilised on an area of interest. Fixations identified by the software were manually coded for area of interest, i.e. patient (patient face, patient body), equipment (AVC technology screen, hardware, other equipment) or other (physiotherapist own body, researcher, elsewhere in the room).
Results: Data from 30 rehabilitation sessions, with 11 physiotherapists and 27 patients, was analysed. Wilcoxon Signed Rank Tests revealed that for all areas of interest (patient, equipment and other) the percentage of fixations, as well as percentage of time, was significantly different between traditional exercise and AVC assisted exercise conditions (p<0.05). During traditional physiotherapy the physiotherapist’s primary focus of visual attention was the patient (median (IQR) was 76(55-88)% of total fixations and 79(57-94)% of total fixation time). Conversely, during AVC assisted physiotherapy the equipment used was the physiotherapist’s primary focus of visual attention, demonstrated with a median (IQR) of 53(41-72)% of total fixations, and 77(58-86)% of total fixation time directed to the screen, hardware, or other equipment.
Conclusion(s): Study results suggest that the use of AVC-based technology in rehabilitation impacts the conduct of clinical practice and that technology use shifts therapists’ visual attention from the patient to the technology equipment.
Implications: Further research is needed to determine how the change of physiotherapists’ focus of visual attention influences the interaction between patient and therapist, and how this impacts on patients’ exercise performance.
Funding, acknowledgements: Heather Weber is supported by an Australian Government Research Training Program Scholarship.
Keywords: physiotherapist visual attention, active videogame and computer-based technologies, rehabilitation
Topic: Disability & rehabilitation
Did this work require ethics approval? Yes
Institution: Flinders University and SA Health
Committee: Southern Adelaide Human Research Ethics Committee
Ethics number: HREC/19/SAC/109 OFR 100.19
All authors, affiliations and abstracts have been published as submitted.
