Bringing Physical Therapy Home for Veterans

The problem

Veterans recovering from neurological injury benefit from regular, targeted exercise. But getting to the hospital for every therapy session can be hard, whether because of their health or simply transportation.

The VA in Baltimore and the University of Maryland set up a pilot program to bring that therapy into patients’ homes: IVET, Interactive Video Exercise Tele-rehabilitation.

Planning it first

Before development, we wrote a detailed task order that laid out the architecture, every screen, and the open questions the clinical team needed to decide, such as who sets the number of repetitions. We then worked out the data model with the client: users and roles, prescriptions, exercise videos, recorded responses, and therapist feedback.

What we built

The system has three parts:

• A web application for therapists: they build each patient’s prescription from a library of exercise videos, setting the order, repetitions, and playback speed limits. They see every patient’s status at a glance, review and grade completed exercises, manage users and videos, and pull reports.
• A web portal for patients: patients review their exercise program and eJournal entries, watch health and wellness videos, and record readings from equipment such as heart monitors and pedometers.
• An Android tablet app for patients: patients view their prescription, calibrate the camera so they’re fully in frame, and exercise alongside a therapist’s demonstration video while the tablet records them.

The app also checked that the camera stayed on for the full length of the demonstration video, a simple sign that the patient had worked through the whole exercise. Recordings upload to the server, where therapists review each patient’s progress remotely and give feedback.

The result

Veterans in the pilot used the system to exercise with their therapists’ guidance, with some help getting started.