By Frank Fornari, Ph.D., Chairman and Co-Founder, BioMech
Artificial intelligence (AI) and machine learning (ML) are transforming the practice of medicine, enabling significant amounts of patient data to be converted and returned to clinicians as actionable and clinically relevant information, guiding diagnoses and treatment decisions. Now, AI/ML are bringing to healthcare a complex, yet powerful, indicator of health: functional motion.
The ability to assess any change in functional motion can be an important part of the early diagnosis and treatment for a variety of health issues, and its restoration is an important outcome. For example, at Virginia Commonwealth University (VCU) Department of Neurosurgery, John Ward, MD, MSHA, is using AI-enabled functional motion analysis to monitor patients’ gait, balance, and cognition throughout the course of treatment for normal pressure hydrocephalus (NPH). Caused by abnormal buildup of cerebrospinal fluid, NPH may affect normal movement and can lead to dementia. It is commonly treated by the placement of a ventricular shunt.
Dr. Ward first assesses a patient’s functional motion pre-spinal tap to provide a baseline. This is followed by ongoing assessments to help guide any appropriate shunt adjustments and necessary treatment changes. Because results are reproducible, which is critical for longitudinal monitoring, they are both clinically reliable and contribute to broadening the understanding and treatment of NPH patients worldwide.
The outcomes realized by Dr. Ward’s NPH patients show why demand is increasing for clinically actionable and objective functional motion data to inform, demonstrate, and evaluate the short- and long-term efficacy of numerous diagnoses and treatments – demand that is now being met by coupling advanced AI/ML with mobile technologies to enable effective, real-time capture of motion data in clinical and real-world settings. Cloud-based analytics software then delivers that information back to providers as precise, accurate and reproducible assessments, therapeutic decision support, and actionable data, stratifying risk, improving outcomes, and increasing the overall efficiency of the healthcare delivery system.
An Essential Biomarker
Advancements in both sensor and AI/ML technologies enable the use of functional motion as an essential biomarker to quantify relevant aspects of physical, surgical, pharmaco, and cognitive therapies. Strategically placed sensors allow for the noninvasive capture of normal and pathological motion data in several key categories to identify, assess, and properly transform a patient’s motion patterns.
For example, gait assessments enable early identification of chronic or acute neuromusculoskeletal pathology, thereby facilitating timely intervention for optimal restoration of proper health throughout the entire treatment process, from diagnosis to discharge or onset to optimal health. Meanwhile, ongoing routine ambulation monitoring can help detect, treat, and correct pathological changes in their early stages.
Another consideration is balance. Essential to activities of daily life, when balance is compromised it is vital that the underlying pathology and appropriate therapeutic approach be quickly identified to maximize treatment outcomes. In fact, incorporating balance as a fundamental diagnostic tool is clinically beneficial across the entire healthcare spectrum – including patients, for whom understanding how to maintain or improve balance can be lifesaving.
There is also a substantial economic impact to be realized. A study in the Journal of the American Geriatrics Society found that $50 billion is spent on medical costs related to non-fatal fall injuries and $754 million is spent related to fatal falls.
A comprehensive assessment of functional motion should also include:
- Symmetry: Because many pathologies manifest as asymmetrical movement, comparing any two points across the midline to determine the degree of symmetry can identify acute or chronic pathology and injury. This data can also be used to optimize the outcomes of physical therapy and corrective exercise.
- Angles: Comprehensive and ongoing range of motion assessments in all three planes (sagittal, coronal and transverse) are clinically meaningful as movement is dependent upon neuromusculoskeletal biomechanics and joint health.
- Cognition: The voluntary motor response to visual stimuli is a fundamental measure of health because it involves sensory perception and cognition. Evaluating these components demonstrates how well a patient can perceive and process stimuli in the environment.
Finally, coupling functional motion data with immediate biofeedback supports compliance with prescribed therapies, facilitates neuromuscular retraining, and can determine progress over time. Regular assessments over the course of treatment—and throughout a patient’s lifetime— help identify issues at their earliest, most treatable stages.
Real-World Applications
As with VCU’s NPH patients, AI-enabled, clinically actionable real-time motion analytics is transforming treatment of traumatically injured patients under the care of clinicians at Independent Neurodiagnostic Clinic (INC). Many of the patients at the Atlanta-based clinic have suffered severe spinal and central nervous system injuries and are seeking not only restoration of functional motion but also relief from debilitating pain.
INC clinicians apply lightweight, wireless, and self-calibrating sensors to patients to capture real-time, high-resolution motion data, which is streamed to mobile or cloud-based analytics software where it is run through AI/ML algorithms. Within milliseconds, that data is delivered back to the clinician and patient in the form of immediately actionable analysis and biofeedback. This same body of data is also used to assess and mitigate fall risk and to quantitatively monitor for medication effects and side effects – delivering transformative results for most patients after a single session.
In the physical therapy setting, functional motion analysis enables an objective, real-time assessment of patients’ status to provide prescribing physicians with information needed to design therapeutic protocols, measure impact, and adjust as needed.
At ēlizur, a multi-state musculoskeletal services provider, sensors and AI-driven analytics have been integrated into its technology-enabled orthopaedic rehabilitation services. The immediate feedback this provides helps therapists optimize patient outcomes and facilitates a permanent positive change in patient movement. The ability to objectively report patient results also helps ēlizur demonstrate the effectiveness of its virtual rehabilitation technology to physicians and payers with streamlined reporting.
A Place in Value-Based Care
The patient results achieved to date support the efficacy and power of real-time, AI-driven functional motion data. This is particularly meaningful for healthcare organizations that have adopted a value-based care model and must demonstrate the quality and cost-effectiveness of their care processes.
Actionable, accessible, and clinically relevant functional motion data enables virtually any clinical specialty to integrate medically necessary tests at the appropriate frequency into comprehensive diagnosis and treatment plans that support value-based models of care.