PT Technology Trends 2023

Technology advances in health care have largely dominated the industry over the last few years. In this blog post we will take a brief look at some of the most recent and relevant technology trends for physical therapy moving in to 2023. The number of available technology tools is vast, so this is by no means an all-inclusive list. However, the tech trends we will focus on are amongst the most popular and heavily utilized in the rehabilitation and performance fields. To make things easier to understand, we broke it up into four Tech Trend categories.

1) Motor Control Devices

One of the most popular trending topics in physical therapy and sports performance has been the contribution of neurocognitive training to rehabilitation. Neurocognitive training (or dual tasking) is when motor and cognitive demands are combined – a scenario that is frequently seen in sports. Our brains work to intricately connect different regions of the brain that receive sensory inputs and produce motions, stability, and movement reactions.[1] A decrease in communication efficiency between these different brain regions is common after injury/surgery and results in movement deficits.[1] Addressing and dissolving these deficits is imperative for performance and injury prevention.

Sports require an athlete to take in signals from their rapidly changing environment and produce an appropriate movement response.[1] The faster and more efficient the brain is at interpreting the information it receives from the environment, the more effective and accurate the resulting action.[2] Initial exposure to dual tasking significantly impairs performance; since cognitive tasks require more attentional resources, they decrease performance when cognitive and motor performance are combined.[2] When dual tasking is trained, however, the cost of dual tasking on performance can be decreased, and overall dual tasking ability can improve. [2] The ability to train dual task performance in rehabilitation can lead to improvements in both cognitive and motor performance, better preparing an athlete for the rapidly changing demands of sports.[2]

When done correctly, neurocognitive training incorporates a variety of cross-model systems (such as vision, sensory, proprioception, reaction) to help increase the activity of the sensory and motor planning networks in the brain, making them more efficient at achieving the proper movement pattern.[3] Since the visual system plays a big role in coordinating and controlling movements during dual task situation, visual stimuli and feedback are the focus of many trending neurocognitive technologies.

How does mTrigger relate to this tech trend? The visual biofeedback offered by mTrigger aids in the motor planning that occurs in the brain following an injury. Refining a motor pattern, maximizing muscle activation, and restoring strength are all essential when addressing the motor piece of dual tasking and neurocognitive training. Read more here.

Other ways to take advantage of this tech trend: https://www.blazepod.com

2) Recovery Techniques

The use of advanced recovery devices has grown exponentially. With advancements in mechanical engineering, pneumatic compression and percussion devices such as massage guns and vibrating foam rollers have taken off. Percussion therapy is used for treating deep tissues with the benefits of pain relief and increased blood flow, increasing range of motion and improving recovery.[4] Vibrating foam rollers and massage guns can be used before or after a performance as they do not affect movement velocity or power.[4] These devices are theorized to work through a mechanism that changes fascial components, hydration levels, piezoelectricity, tone, sympathetic drive, and viscoelastic properties of the involved tissues.[4,5]

Research has discussed a few practical applications for percussion therapy. First, percussion therapy can be used to help improve range of motion at a joint, say the ankle, without affecting the strength producing capacity of that muscle group (gastroc in this case) immediately before an event.[4] In contrast, static stretching has been shown to decrease power when performed immediately before an event. Second, utilizing percussion therapy between sets of a resistance training exercise can help improve recovery between sets and allow for more reps before fatigue sets in.[4] Third, vibration therapy can help to restore relative strength after exercise faster than passive rest alone.[6]

Like most things in rehab and performance, the parameters with which vibration therapy is applied can greatly change the effects of the treatment.[6] Massage guns are designed to elicit compression forces at a frequency relative to the amount of pressure the user is applying. Lower frequency vibration can be effective at speeding up recovery by increasing blood flow to and from the working muscle, decreasing tension, and has an overall relaxing effect.[6] Higher frequency vibration, on the other hand, excites the central nervous system, increases muscle tension, and quickly warms local tissues.[6] One benefit to these recovery tools is that athletes can use them independently, meaning they can be used daily without having to wait on the schedule of a clinician. Application times of 30 seconds to 5 minutes appear to provide improvements in recovery and performance.[7]

Another popular recovery device amongst endurance and strength athletes is pneumatic compression.

Intermittent pneumatic compression (IPC) helps to provide immediate pain relief from the results of prolonged exercise, including the onset of delayed onset muscle soreness (DOMS).[8] In resistance training athletes, IPC can help attenuate the flexibility losses that result from heavy resistance training (from a neurological perspective), decreasing the pressure to pain threshold, and subsequently limiting the amount of soreness after training.[9] Furthermore, it is common to see an increase in serum creatine kinase markers 48hrs after heavy resistance training.[9] The use of compression garments (static or pneumatic) has been shown to reduce these serum markers of muscle damage and decreased strength/performance.[9] The effects of intermittent pneumatic compression devices appear to be short term in nature, improving immediate recovery, but having little impact on the longer 1-2 week recovery periods.[8] However, endurance and resistance athletes still report a reduction in muscle pain, soreness, and overall muscle fatigue after the use of IPC.[8]

How does mTrigger relate to this tech trend? mTrigger doesn’t’ really have a role in the recovery space. However, we do want to recognize that this area of technology is making a lot of headway. If you’re looking to explore relaxation training with biofeedback, check this out.

Other ways to take advantage of this tech trend: https://hyperice.com

3) Human Measurement Technologies: Range of Motion, Strength Testing, and Motion Analysis Devices

In physical therapy, the ability to quantify changes in range of motion and strength are critical for tracking and documenting progress in rehabilitation. Historically, goniometers, inclinometers, visual estimates (“eye balling”), and manual muscle testing have been utilized by clinicians to help measure and track joint range of motion and strength.[10] Unfortunately, these simple and universal methods leave room for human error and their validity and accuracy have come into question.[10] New methods such as smart phone devices, force plates, strength testing systems, inertial sensors, and motion tracking systems have shown promise when it comes to assessing joint range of motion, strength, and movement.[10] Handheld dynamometry is a common tool used to access muscle strength; however, several variables can impact its reliability, such as tester strength, lack of stabilization, and varied testing positions/protocols.[10] Newly designed strength testing devices and platforms are hands free, portable, height adjustable, and offer enhanced stability for the best and most accurate results.[10] This allows clinicians to better track progress, address deficiencies, and make safe return to sport decisions.

The development and innovation of force plates, jump mats, and motion capture systems has allowed us to better understand the mechanisms of movement, instead of just the final outcome of the movement.[11] Force plates and jump mats provide an in-depth look at jumping / landing metrics and contact forces that were previously unavailable outside of high-tech research labs. Motion capture is widely used amongst sports medicine providers and biomechanists to help study and breakdown components of a motion or movement that might correlate to injury.[12] Motion capture provides feedback to the athlete to help support motor learning through the visualization of movement.[10]

Wearable sensor systems can now be found embedded in shirts, shorts, or sleeves providing information on range of motion, inertia, gait speed, joint angle, or acceleration.[12] The improvements in these wearable devices has expanded the playing field, allowing for better feasibility to measure sport-specific movements outside of the lab and in an actual sporting environment.[12]

Gathering more accurate data from strength testing, ROM devices, force plates, motion capture, and wearable systems allows clinicians to measure and monitor the load and force for each individual. This becomes increasingly important when dosing the “right amount” of training or load for each individual athlete, which is an intricate balance between training, recovery, performance, and injury prevention.[11]

How does mTrigger relate to this tech trend? mTrigger’s neuromuscular deficit testing function can be used to measure and track strength deficits over time. Read more here.

Other ways to take advantage of this tech trend: https://valdperformance.com

4) Virtual Reality

When we think of virtual reality, we often imagine a pair of funny goggles and a fun animated game. Although not completely off, virtual reality uses 3-D real time simulation through a user-computer interface that creates similar sensory information to the real world with enhanced feedback for patient learning.[13] This concept can also be very useful and effective in the rehabilitation sphere. VR is used in a wide range of settings, from outpatient clinics and home-based settings to rehabilitation facilities.[13] For physical therapy, VR programming creates an avatar of the subject to then create virtual reality movement that matches the subjects’ movements, generating a large amount of visual and sensory feedback during an exercise.[14] The goal of virtual reality is to improve the motor performance of a task. Repeating a motor pattern over and over again under the enhanced stimulation provided by virtual reality helps patients achieve the best motor performance possible through activating, refining, and reinforcing the motor learning process.[13] As just a few examples, VR is used to help with balance and mobility exercises in aging populations or after stroke; for home-based rehabilitation initially after surgery; and for common orthopedic conditions such as shoulder impingement.[13,14]

Augmented reality is like virtual reality but without all the bells and whistles. Typically, AR creates an environment where real and artificial are mixed. Increased auditory, textual, or visual feedback is used to help improve or correct a patient’s movement.[15]

Overall, virtual and augmented reality provide a greater motivation and a more enjoyable experience for the patient both in the clinic and at home.[15] In fact, studies are showing increased adherence and greater improvements in pain and function when home exercise programs incorporate some form of virtual or augmented reality.[14] For this reason, home based rehabilitation programs driven by tablet apps and mobility monitoring systems are growing in popularity for patients.[16] Using virtual/augmented reality also helps increase joint perception and body awareness of an individual during exercises and in daily activities.[14] This has a drastic effect on the timing and outcomes of rehabilitation.

How does mTrigger relate to this tech trend? mTrigger uses gamification to add a unique twist to exercises. By using sEMG biofeedback to navigate through challenges and games, exercises become more fun, and effort increases. Read more here.

Other ways to take advantage of this tech trend: https://www.realsystem.com/

*mTrigger does not clinically recommend the use of these products. mTrigger, LLC is not endorsed to promote the products mentioned in this post.

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References

1. Diekfuss JA, Grooms DR, Bonnette S, et al. Real-time biofeedback integrated into neuromuscular training reduces high-risk knee biomechanics and increases functional brain connectivity: A preliminary longitudinal investigation. Psychophysiology. 2020;57(5):13545. doi:10.1111/psyp.13545
2. Moreira PED, Dieguez GT de O, Bredt S da GT, Praça GM. The Acute and Chronic Effects of Dual-Task on the Motor and Cognitive Performances in Athletes: A Systematic Review. Int J Environ Res Public Health. 2021;18(4):1-13. doi:10.3390/IJERPH18041732
3. Gokeler A, Benjaminse A, Hewett TE, et al. Feedback Techniques to Target Functional Deficits Following Anterior Cruciate Ligament Reconstruction: Implications for Motor Control and Reduction of Second Injury Risk NIH Public Access. Sport Med. 2013;43(11):1065-1074. doi:10.1007/s40279-013-0095-0
4. García-Sillero M, Jurado-Castro JM, Benítez-Porres J, Vargas-Molina S. Acute effects of a percussive massage treatment on movement velocity during resistance training. Int J Environ Res Public Health. 2021;18(15). doi:10.3390/IJERPH18157726/S1
5. Alonso-Calvete A, Lorenzo-Martínez M, Padrón-Cabo A, et al. Does Vibration Foam Roller Influence Performance and Recovery? A Systematic Review and Meta-analysis. Sport Med – open. 2022;8(1). doi:10.1186/S40798-022-00421-2
6. Chwała W, Pogwizd P, Rydzik Ł, Ambroży T. Effect of Vibration Massage and Passive Rest on Recovery of Muscle Strength after Short-Term Exercise. Int J Environ Res Public Health. 2021;18(21). doi:10.3390/IJERPH182111680
7. Cheatham SW, Baker RT, Behm DG, Stull K, Kolber MJ. Mechanical Percussion Devices: A Survey of Practice Patterns Among Healthcare Professionals. Int J Sports Phys Ther. 2021;16(3):766-777. doi:10.26603/001C.23530
8. Stedge HL, Armstrong K. The Effects of Intermittent Pneumatic Compression on the Reduction of Exercise-Induced Muscle Damage in Endurance Athletes: A Critically Appraised Topic. J Sport Rehabil. 2021;30(4):668-671. doi:10.1123/JSR.2020-0364
9. Haun CT, Roberts MD, Romero MA, et al. Does external pneumatic compression treatment between bouts of overreaching resistance training sessions exert differential effects on molecular signaling and performance-related variables compared to passive recovery? An exploratory study. PLoS One. 2017;12(6). doi:10.1371/JOURNAL.PONE.0180429
10. Beshara P, Davidson I, Pelletier M, Walsh WR. The Intra- and Inter-Rater Reliability of a Variety of Testing Methods to Measure Shoulder Range of Motion, Hand-behind-Back and External Rotation Strength in Healthy Participants. Int J Environ Res Public Health. 2022;19(21):14442. doi:10.3390/IJERPH192114442
11. Raymond F, Lussier B, Dugas F, et al. Using Portable Force Plates to Assess Vertical Jump Performance: A Metrological Appraisal. Sports. 2018;6(4). doi:10.3390/SPORTS6040149
12. Lapinski M, Medeiros CB, Scarborough DM, et al. A Wide-Range, Wireless Wearable Inertial Motion Sensing System for Capturing Fast Athletic Biomechanics in Overhead Pitching. Sensors (Basel). 2019;19(17). doi:10.3390/S19173637
13. Rutkowski S, Kiper P, Cacciante L, et al. Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis. J Rehabil Med. 2020;52(11). doi:10.2340/16501977-2755
14. Pekyavas NO, Ergun N. Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: Short term effect. Acta Orthop Traumatol Turc. 2017;51(3):238. doi:10.1016/J.AOTT.2017.03.008
15. Gil MJV, Gonzalez-Medina G, Lucena-Anton D, Perez-Cabezas V, Del Carmen Ruiz-Molinero M, Martín-Valero R. Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis. JMIR Serious Games. 2021;9(4). doi:10.2196/30985
16. Hoogland J, Wijnen A, Munsterman T, et al. Feasibility and Patient Experience of a Home-Based Rehabilitation Program Driven by a Tablet App and Mobility Monitoring for Patients After a Total Hip Arthroplasty. JMIR mHealth uHealth. 2019;7(1). doi:10.2196/10342