The Future of Sports Medicine

Source: Georgia Tech Engineers Magazine

Not only the experience of sporting activities and events, but also rehabilitation after sports injuries are changing due to cutting-edge technologies. In sports medicine, the future holds a shift towards prevention through genomics, nutrigenomics, countless trackers and wearables, while there are many great technologies which aim to alleviate the pain and shorten the time of recovery – if, against all odds, a sports injury still happens.

Technology will change the experience of sports injuries and rehabilitation

When was the last time you went out for a run without Endomondo or had a bike tour without Strava? Have you thought about how different the commentaries for live football or basketball matches were only a couple of years ago? Where were those sixteen cameras that have been monitoring the field and performance of football players since 2007? Where was the hawk-eye technique to track the trajectory of balls in cricket or tennis before 2001? What about professional timer services? Who saw whether the ball was in or out if not the camera?

The experience of sports and following sports events radically changed in the last two decades due to technology. The assessment of performance, the training methods, the episode of cheering for your team – all activities connected to sports have been hijacked by technology.

The most painful event of them all, being a victim of a sports injury, is no exception either. There are many technologies which aim to improve the state of sportsmen and sportswomen going through the rough period of recovery, as well as technology-based methods to prevent those injuries. The appearance of the following tools falls neatly in line with the general trends, namely that there is a palpable shift from proactive to preventive medicine.

Here, we collected the most relevant and exciting examples, which could help professionals in sports medicine make sportsmen and sportswomen less prone to injuries and if an accident happens they can recover in less time.

Preventing sports injuries

Technology gathers data about every second of the performance of the players during training or the actual race. Data not only helps to analyze, create new strategies and thus boost players’ performance in the arena but can also monitor health state and warn about overstraining. Current scientific achievements also give the chance to sports fanatics to dig deeper and discover what health risks they carry in their genes or what diet they should follow to stay on top for a long, long time.

1) Preventive genomics

What if your genes could tell you how you should change your work-out or your overall training to prevent injury? Or what kind of nutritional demands do you have? Wouldn’t life be more comfortable if you could personalize your training regimen or your diet based on your genetic background?

It is already possible. The Nova Scotia-based performance company, Athletigen Technology Inc. works with several athletes aiming to use collected DNA information to improve performance, health, and safety. These genetic tests reveal additional insight about a possible heightened risk of injury or specific nutritional demands. Later, these results allow the helpers of an athlete to adjust his or her workout plan and nutrition accordingly.

With regards to the appropriate diet plan for athletes, the new field in dietetics, nutrigenomics could be the answer. In my case, the data of my entire DNA sequence at home in a digital file showed that I’m sensitive to caffeine and process alcohol more thoroughly than most people (I’m Hungarian after all). But you don’t have to figure out this information by yourself. There is a California-based start-up, Habit, which might help you with that. If you send back their required blood sample kit, they will analyze your DNA, and create a personalized meal plan that works best for your body. The spread of nutrigenomics could be of massive help for athletes to find the right diet boosting their performance to reach new records and make their immune systems stronger to fight off diseases and prevent injuries easily.

2) Monitoring health through sensors and wearables

There is a gazillion of healthcare wearables and sensors out there which aim to support training, keep sports professionals healthy while help them reach their very best. Most of the time, they offer constant health data management, real-time performance monitoring, and immediate feedback. We already know about Pebble Time and the Android Sleep App which follow your sleeping habits; Fitbit Surge or Fitbit Ionic tracking your fitness activities, while PIP giving you an overview of your stress levels.

However, there are many specialized tools for monitoring the stress load and performance of players to avoid fatigue-induced injuries. For example, athletes who do lots of jump roping during their training might want to try Vert. It helps them measure and improve their jumping capabilities; and know when they are nearing an unsafe level of fatigue that may lead to injury. Blast Motion does something similar. It tracks and analyses players’ swings during training to optimize performance and decrease the risk of injury.

Osman Hassan Ahmed, a physiotherapist to the Football Association in the UK, told The Medical Futurist that in the future, sportswear will be able to show the clinician standing at a playfield’s sidelines vital physiological data in real-time. That will enable them to gain an accurate picture of the individuals’ status;and combining this with GPS data may also help to make decisions as to when to substitute the player in a match or to remove him from the field of play when training, he added.

3) Prevention through sensory garments, helmets, mouth guards

The Australian company, Catapult Sports is considered one of the biggest suppliers of sports tracking devices. More than 1500 professional teams are using their trackers worldwide. Players wear their small, pocket-sized GPS trackers on the back of their training tops, and the device tracks over 100 metrics from speed through heart rate until acceleration. As a consequence, the coach can monitor players’ information on the sidelines in real time – just as Hassan Ahmed said. Players in the National Football League wear the chip of Zebra Technologies on their shoulders that send data to receivers placed around the stadium.

Maryland-based Zephyr Technology backed by Medtronic produces among others a bio-harness, which allows coaches to see the intensity of a specific training regarding biomarkers, such as heart rate, temperature or acceleration. The company’s trauma-monitoring patches that stick to the player’s body measure force and impact so that specialists could have more data about concussion risks for football or hockey players.

Beyond gadgets, imagine chips and clothing measuring vital signs and devices boosting performance actively! Many athletes in professional clubs now wear unique shirts that measure their vital signs during practice or even games. HexoSkin developed a shirt with sensors woven into it that measures heart rate, breathing, number of steps, pace, and calories burned. The London-based D30 introduced a smart material this year. It provides terrific shock absorption and impact protection capabilities, which are naturally an ideal fit for basically every sport.

In the future, many high-contact sports, where players have to use helmets for their safety will utilize high-tech hard-hats. These helmets utilize shock absorbers that release air when the head has suffered an impact. This air inflates the protective interior of the helmet and reduces the amount of quick movement the head sustains, thus reducing the chance of a concussion. Special mouth guards can now even alert athletes if they are at risk for a shock: sensors warn the player when an injury that could lead to a concussion has occurred.

Sports injury rehabilitation

As the Tao says, injuries happen. Technologies might decrease the occurrence rate, but accidents will still occur in the future. However, state-of-the-art diagnostics and appropriate rehabilitation tools could shorten the time of recovery and alleviate the pain along the way to feel well again.

Regarding diagnostics, portable medical devices and real-time visualization will make a difference in the future. Osman Hassan Ahmed says that musculoskeletal ultrasound is becoming more common in elite sport. He thinks that’s a forward-looking solution, but it would be great if the technology emerged to a level where a clinician could have an on-pitch scanner which could work through clothing and wouldn’t need conducting gel. Start-uppers – here’s an idea for success. Go for it!

1) Revolutionary rehabilitation technologies: anti-gravity treadmill, exoskeletons

After breaking a bone, injuring a knee or rupturing a ligament, it takes much time and a long rehabilitation process to be able to do sports again. The AlterG Anti-Gravity Treadmill allows patients to work out without bearing their full body weight. The machine can take over between 20-100 percent of the original weight enabling to move muscles and bones without overstraining them. The treadmill could do wonders not only in sports rehabilitation but also in neurological, orthopedic, senior rehabilitation or with weight loss. Another product of the company, the Bionic Leg provides patient-initiated motor assistance during sit-to-stand exercises, overground walking, and stair climbing. It strengthens weak muscles, increases balance, and helps patients to learn faster how to walk again!

Going one step further, complex robotic structures called exoskeletons could also support rehabilitation in the future. They could help the recovery of stroke or spinal cord injury patients, and already let paralyzed people walk again. For example, a gait-training exoskeleton suit helped Matt Ficarra, paralyzed from the chest down, walk down the aisle on his wedding day! How amazing is that?

2) HawkGrips, dynamometers and exercising machines

Sometimes the worst stories have the most hopeful endings. In 1997, Frank Osborne broke his neck, back, wrist, arm and both shoulders in a terrible ski accident. As a result, he struggled with debilitating pain for more than a decade. Thirty surgeries, extensive physical therapy, and alternative treatments offered little help. Until he met Instrument Assisted Soft Tissue Mobilization (IASTM) treatments, where a hard-edged instrument made of metal, plastic or ceramic is used to add shearing stress to soft tissue to enhance the body’s healing response. The method was so effective that he promised to make the best instruments for the technology. That’s how HawkGrips was born.

The Baltimore-based international company, BTE, offers complex rehabilitation systems in over 35 countries. It has various rehabilitation equipment, such as the Primus RS dynamometer or the Eccentron, resistance trainer. The former evaluates patients’ movements – how firm their grip is, whether they can lift a box – so the physician can assign the appropriate rehabilitation exercises for them. In case of the Eccentron, the exercising machine is an essential part of both rehabilitation and performance enhancement. It targets purely eccentric exercise for both assessment and then sets up an appropriate training program.

3) AR/VR in sports medicine

Although virtual reality and augmented reality are already used in several medical specialties, their application in sports medicine is limited, explained Osman Hassan Ahmed. However, given the unique demands of this discipline, he believes that blending existing evidence-based rehabilitation strategies with cutting-edge VR technologies which could replicate the players in their own stadium, the noise of the fans would be a valuable adjunct.

 

Fortunately, there are already some positive examples leading the way to the full-blown utilization of VR in sports medicine. Israeli start-up VRPhysio harnesses the power of gaming technology to help treat neck, spinal and other injuries through VR and rehabilitating games. It has created a platform that makes physiotherapy exercises easily accessible and enjoyable to patients, while also being easily monitored and analyzed by doctors and physiotherapists.

In the future, the appearance of VR/AR will be more frequent in sports medicine. Some visualize an augmented reality app which helps physicians check the collisions of players in real time sitting on the bench next to a trainer, assess the impact and make the decision whether or not a player should be taken off the field. It’s a wonderful idea, and just as AR could assist surgeons before complex operations or med students in their practice, this app might be used both for training or in real sports events. Here, another way to disrupt medicine and another idea for start-uppers. The future indeed seems to be exciting!

Just as every other specialty, sports medicine will change a lot due to AR/VR, trackers, wearables or exoskeletons. The challenge is to learn how to use those technologies to make sports medicine physicians better at their job without losing the human touch. Patients need interaction while they can enjoy the benefits of using digital health.

 

 

fonte: http://medicalfuturist.com/future-of-sports-medicine/?utm_source=The+Medical+Futurist+Newsletter&utm_campaign=8f3296388b-EMAIL_CAMPAIGN_2018_04_17&utm_medium=email&utm_term=0_efd6a3cd08-8f3296388b-420549885

Examples of Gamification in Healthcare

Why is it so hard to change?

Sequin dresses, champagne and smiling faces counting down to the new year. Some kisses here and some resolutions there. This time, Samantha thought everything will be different. She made a resolution every year to change her lifestyle into something fitter but she could not make a lasting change in the long run. But this time, she was absolutely determined. In the first weeks of January, she bought new shoes and active wear, she started to spinning class twice a week and promised herself a biking weekend as a reward in the spring.

But then in February, Jim’s birthday celebration collided with her work out session, so she missed it out. Afterward, her mom needed to be brought to the hospital due to chest pains, while another time her fridge broke and needed to wait for the technician. March was already upon her when she realized – she does not go to the gym anymore.

Her story is one of ours, no matter whether it’s about sports, eating, reading more or working less. I spoke to Jurriaan van Rijswijk, Chairman of the Games for Health Europe Foundation, about why it is so hard to adopt new habits. The gamification expert said that motivation is one factor in changing behavior, but loyalty towards the subject of change is something people usually don’t consider. The money versus time issue is often why desired long–term behavioral change fails. So instead of trying to buy your way into change with sport clothing items or pricey devices, at first, you should start spending time exercising with limited resources and technology. Then gradually the new behavior becomes valuable, and you will spend more and more of your valuable time doing it.

Technology can be your coach supporting lasting change

The key to success is time commitment or loyalty to the subject. Both are really hard to reach, but there are factors making it easier. Some people are motivated by the feeling of community and socializing, others by getting rewards for certain achievements, competing against others, looking at data and measurements about small successes or making the whole process fun.

Technology can combine many of these factors and could become a resource liberating tool helping us spend more time on the desired goal. I have been measuring my health parameters and vital signs for years. I know that sometimes I run for another ten minutes just to beat my score from yesterday. However, there are many people for whom it is not enough motivation if you show their raw data, they need challenges, rewards or some community. Gamification can do the trick for them.

Gamification is the new buzzword in healthcare

Game play focuses and controls our attention, taps into our innate strengths, thrills us utterly, and compels us to greater resilience in the attainment of more powerful and effective skills. That’s why many believe it is perfect for behavior change in healthcare. A game is more than the automatic collector of vital signs and notifications. Gamified services engage us, keep us motivated and helps us down the bumpy road of change. It’s the combination of a great buddy and a considerate parent. That’s why I believe gamified solutions will spread like epidemics in healthcare as well.

But it is really difficult to find the right balance for digital tools to act as sources of motivation not turning into burdensome constraints or “digital whips”. In 2016, Fitbit announced that it was partnering with employers, corporations to track employees and mine that data in order to monitor employee health habits. Fitbit was introduced way before in several companies as “the corporate fitness tracker” creating common challenges and competitions for employees – which is fun and motivating. In an interview, Adam Pellegrini, VP of Digital Health for Fitbit told me Houston Methodist implemented a month-long step challenge where employees went head to head with their departmental CEOs. Average daily step count to beat was 16,000! Now that’s what I call a challenge!

But imagine that your boss knows about your fitness goals, sees your data – and has the capacity to forward it to the health insurance company deciding about your premiums! Imagine that you are making a lot of effort to lose weight but still your employer considers that it is not enough… Where are the boundaries of a motivating tool? How far could employers, moreover health insurance companies go when it comes down to the health or fitness issues of their employers or users? Complex and difficult questions which need to be answered soon!

Great game design is difficult

As you could already discern from the above, game design is a very difficult area. You need something which pulls you in but does not make you toxically addicted, which is fun but also informative, which creates achievable but not that easy challenges. Not to speak about the most problematic part of a gamified device or app: its ability to achieve lasting change.

There was a recent study which examined the effects of Pokémon Go. Shortly after the release of the little monster hunting adventure, there was a lot of enthusiasm that it would be a healthy addiction by getting users more active. Pokémon Go players’ steps went up from an average of 4256 steps per day to 5123 steps in the first week of playing the game. After that, though, there was a gradual decline back to where they started by the sixth week. That pattern was consistent across various subgroups based on neighborhood walkability, income level, age, and more.

However, there are good examples of apps and services that provide motivation, rewards and reinforce commitment. If we respect the fact that it will only work when participation is voluntary and self-motivated, they could really help in achieving great things. Here, I collected some of the most widely known game-based digital technologies in healthcare.

1) Physical fitness

I already mentioned Fitbit & Co: how common challenges can be set up through the Fitbit community interfaces and how competition could motivate better gym performances and step counts. EveryMove also counts on your competitiveness. It collects data from trackers and apps we already use to allow friends to compare one another’s progress. Social motivation, such as seeing that my friends went for a run today but I haven’t yet, is a strong one.

Blue Shield California, a not–for–profit health insurer, attempts to make wellness fun via social media. Participants earn points, badges, status, and see their progress. Blue Shield claims that 80 per cent of its employees have participated, and had a 50 per cent drop in smoking prevalence.

CaféWell does something similar with its health programs. It is focusing on giving guidance and support to people who want to live a healthier life. In its personalized programs, they focus on your own needs in order to eat better, incorporate exercise into your life, reduce stress or walk that extra mile. The app called Pact goes even further: it tracks fitness progress on mobile devices, and those members who don’t meet their fitness standards have to contribute money to a fund that rewards members who do meet their standards. The idea is simple: if you have to pay for something with your hard-earned money, you will think twice before growing lazy.

2) Medication and chronic condition management

Mango Health developed a smartphone application designed to motivate patients to take their medications on time. Users set the times when medications should be taken, and the app reminds them. It also provides information about the medications and warns about drug interactions and side effects. By taking the medications properly, users earn points towards gift cards or charitable donations in raffles held weekly.

Bayer’s Didget blood glucose meter, which connects to a Nintendo DS gaming platform, is intended for kids between 4 to 14. It helps manage their diabetes by rewarding them for consistent blood glucose testing. As points accumulate, new game levels and options unlock. There are leader boards with kids who collected the most points, web games and an online community as well.

The Austrian startup, mySugr also offers its gamified solutions for diabetes management in a fun way both for children (mySugr Junior app) and adults. As the creator of the cute diabetes monster, mySugr has already over a million registered users, is available in 52 countries and in 13 different languages. It was recently acquired by the global pharmaceutical company, Roche.

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3) Gamification for kids

It is especially important to apply gamification for medical solutions aimed at children as they usually do not understand the importance of therapies or drugs for their health, in the long run, they just consider the short-term miseries. They do not want to swallow bitter pills or eat vegetables, do not want to go to therapy or stay in the hospital. Gamification can help forget kids that they are undergoing therapy or medical treatment. If they believe they are swallowing the secret of a long-gone civilization with the pill and only their enteric bacteria could decipher that code, they would gladly take any drug.

For example, the American Red Cross developed an app called Monster Guard focused on helping prepare children for emergencies. It teaches kids through “Monster Guard Academy” how to prepare and stay safe during home fires, hurricanes, floods or other disasters, and they get points and medals for completing tasks.

Raising a health-focused and fit child is also easier through gamification. Leapband or Vivofit jr., for example, encourages kids to stay on the move. The latter tracks steps, sleep and 60 minutes of daily recommended activity. Kids are able to earn coins to redeem for agreed-upon rewards, while parents can monitor the kiddos’ steps and active minutes, assign chores and even hand out those virtual rewards.

4) Physical therapy and rehabilitation

After a serious injury or a stroke, it is difficult and time-consuming to reach even an agreeable level of independence regarding movement or other activity. If you have trouble imagining what it’s like to tackle everyday challenges after waking up from an accident, try the SCI Hard gaming app developed by the University of Michigan. Gamified therapies could help in making rehabilitation more fun, stretching abilities playfully and divert attention from pain. Reflexion Health uses a video feedback system to correct the movements of patients practice physical therapy based exercises. The system works in patients’ homes. Movements are modeled by animated figures. Motion guided technology compares patients’ movements with those of the models and gives guidance and correction suggestions.

A Canadian company, GestureTek Health develops applications specific to health, disability, and rehabilitation. Its VR exercise programs enable patients to have fun while stretching their physical and cognitive capabilities. MindMaze created devices, which use virtual reality, brain imaging and gaming technologies to retrain the brain in stroke victims. It also works on solutions for spinal cord injury and amputee patients.

In the medical world, compliance is the word that is used to describe to what extent patients abide themselves by the therapy. Yet, as patients are more and more empowered, the expression becomes more and more offending as it assumes that patients are blindly following the doctor’s commands and do not follow recommendations voluntarily. Instead, they want to actively take part in their health, they want the patient-doctor relationship to be on an equal level. Instead of compliance, they want to be motivated on the long-run.

With digital health powered healthcare in the future, gamification will be the help already motivated patients need in order to stick to therapies without burdening efforts.

 

 

 

fonte: http://medicalfuturist.com/top-examples-of-gamification-in-healthcare/?utm_source=The+Medical+Futurist+Newsletter&utm_campaign=3d8b44f2b2-Newsletter_2014_07_177_17_2014&utm_medium=email&utm_term=0_efd6a3cd08-3d8b44f2b2-420549885