What Does it Take to Create IoT-based Post-Fracture Rehabilitation Control System

A bone fracture is a traumatic injury that is commonly associated with accidents or from the physical stress of competitive sports. Aside from being painful and “memorable” for all the wrong reasons, bone fracture injuries have one of the hardest paths to physical rehabilitation.

Not only is patient restricted in movement due to the fragile nature of the damaged bones, but he or she is also in danger of muscle apathy and joint stiffness if don’t move more often. It’s a "damn if you do" and "damn if you don’t" scenario.

Also, don't forget that traditional post-fracture therapy requires physical interaction between the physiotherapist or physician and the patient. This is needed to properly guide the patients on the right exercise or stretching routine and to monitor their recovery progress.

A post-fracture rehabilitation control system based on Internet-of-Things can greatly ease the burden of physical travel for injured patients as well as give therapists an economical and effective way to monitor all their patients.

Advantages of an IoT-based solution to control post-fracture rehabilitation

Technology is playing a large role in improving the experience for both therapist and patient when dealing with post-fracture rehabilitation.

For Patients

1. A newly injured patient or those with acute injuries will not be forced to travel for therapy sessions which could lead to possible injury aggravation and delay healing.
2. Patients can rehabilitate in the comfort of their homes and only return to the physiotherapist or clinic for routine checkups.
3. An IoT-based post-fracture rehabilitation solution will be more economical for patients because they save on travel expenses and time. This will also be a cheaper alternative than hiring a personal therapist.
4. The remote therapy sessions will be better for those suffering from injuries that prevent them from walking or supporting their weight (e.g. Hip injuries, fractured leg).

For Orthopedic doctor

1. Aside from the initial medical evaluation at the hospital, doctors can monitor the patient’s progress remotely via reports generated by a post-fracture rehabilitation app based on IoT or via live video monitoring.
2. The doctor can service multiple patients, thus saving time and allowing them to look after more patients.

For Post-Fracture Physiotherapists

1. Using remote monitoring via the IoT-based post-fracture rehabilitation app, the therapist can service multiple patients simultaneously, giving them more clients and revenue.
2. This can allow the physiotherapist to concentrate on patients that still need physical assistance (e.g., newly fractured patients).

For Hospitals or Orthopedic Clinics

1. After the initial checkup or session, the facility can then place recovering patients under remote monitoring allowing them to take in more clients.
2. The facility can then put all its attention on patients that need special care or people needing to use special orthopedic equipment (e.g. patients using lumbar stretching beds).

A closer look at how to develop an IoT-based solution to control post-fracture rehabilitation

This IoT type of app is developed by combining different technologies to create a complete medical solution. Some of the technology used, like video monitoring, are common and have been available for years. While some, like IoT wearable devices, are quite new and is just now entering general acceptance and use. Let’s look closely at the parts and processes needed to make your own post-fracture rehabilitation system as an IoT app.

Below is a table we tried to compare the development of an IoT-based post-fracture rehabilitation solution and a traditional orthopedic therapy service.
 

	IoT Post-Fracture Rehabilitation App	Regular Post-Fracture Therapy
Facility or Infrastructure needed	It will take a few months to develop the app.	An orthopedic clinic can be set up in a few weeks.
Facility or Infrastructure needed	Does not require a venue to rent or own. Can scale and accommodate more patients.	Requires renting or owning a clinic space. Scaling means investing in more rooms or space.
Service	The service can be offered to anyone, anywhere.	The service can only be offered to those local patients.
Service	The app will rely on the discipline of the patient to undergo physical therapy and involve strict compliance with the therapy programs.	Physiotherapists have to push the patients to perform all exercises and physically gauge their condition.
Service	Ideal for newly injured, elderly, and those lacking mobility. Saving them from the rigors of travel.	Patients, no matter the strength level or extent of the injury, will need to go to a clinic for therapy physically.

Features to be considered

As mentioned, this IoT service will require different technologies to create a working system. Below are features to be considered when creating the service.

1. Works as a wearable device - there should be a way to monitor and record the patient's movements. This is for the therapist to check if the exercises are being done correctly. Capturing the speed and angle of movement is also an effective way to monitor the patient's progress. The device, if capable, can also monitor heart rate, which can also be an indicator of patient health.
2. Connects to a cloud network - for the service to work anytime and anywhere, it should be able to connect to a cloud environment. The cloud server can retain all patient files, which the physicians and therapists can then access.
3. Remote video monitoring - a live video feed showing the patient performing their post-fracture exercises and can be used by the physiotherapist to convey instructions.
4. Alarm system - the system should be able to detect sudden or jerky movements and impact caused by a fall. The system can send an alert to the physician or assigned remote therapist who can verify possible injuries and send emergency personnel.
5. Reporting - the system should record all patient activities and progress. There should be an option where a patient can report pain or observed abnormalities (e.g. a bruise or a lump)

Cost to develop

Anyone who wants to develop their own post-fracture rehabilitation system as an IoT app needs to understand the technical requirements of building this IoT App. Below is a list of requirements starting from the end device or client user interface, the infrastructure, and the core system.

Cloud server

The main location of the management system and repository of stored video files, recordings of patient exercises and a log of activities and observations from the patient, physiotherapist, and physician. As with any server requirement, this can also be a physical hardware server configured to be accessed remotely.

Cost: This will depend on the scope of the project and can range from $100 to $300 monthly for the initial setup.

You can scale to a bigger server, $1,000 to $5,000 monthly, when the number of users increases since the recorded video and motion capture files require large data storage.

A reliable cloud service provider should ensure stable network access. We recommend using Amazon Web Servers (AWS) as a cloud service provider and as a reference, here is Amazon’s pricing for AWS cloud servers.

Wearable motion sensors

This assumes that you will use a separate add-on for motion capture that will connect to a smart mobile device. This device should be small, can be attached to the affected area (e.g., limb or shoulder) and can connect to a smartphone via wireless using Bluetooth (recommended) and Wi-Fi or physical wires. An example would be the Wear Notch motion capture device.

Cost: One sensor kit with multiple nodes will range between $300 to $400 (customization and branding included).
This can be optional, as the app can use the built-in accelerometers of smartphones to handle motion sensing.

Development of the system

This system will require seasoned app developers and the manpower or labor cost should be part of the overall project cost.

This is considered an enterprise-level app because of the motion sensing requirements, use of GPS to monitor walking or jogging and possible integration with a 3rd party sensor device.

Below are items to be included in the development cost.

• IoT user control system - this is the main user interface and should contain the main monitoring system (video and motion capture) as well as a way for the physiotherapist to communicate with the patient.
• Smartphone sensor reading - sensor signals like GPS can monitor distance and speed of movement real-time.
• Authentication - a user authentication system for the end user, physiotherapist, and physician. The sensitivity of data should be safeguarded by secured access.
• Integration with a device sensor can be an optional feature as current wearable motion devices are still expensive. This can be offered as a premium service to recoup the cost of the devices.
• Messaging system - this is important as it gives the physiotherapist direct access to the patient, thus being more effective in monitoring each stage of recovery.
• Physiotherapy monitoring panel - this can be a web browser viewing platform that can be accessed by the user, the physiotherapist and, authorized personnel. This will serve as the access point for recorded videos, files, and reports. Here the doctor and patient can communicate using video, simple messages, images and recorded voice messages.

Cost: $100,000 up to as high as $500,000. Integrations to wearables can add between $10,000 to $100,000.

Development timeline

An IoT-based system to control post-fracture rehabilitation that can effectively mimic the experience and effect of a traditional therapy session will take approximately six (6) months to develop.

Overview of the development process

• Planning business rules and how the app can measure and monitor a patient’s status.
• Gathering app and site requirements from consultants and medical personnel who have experience in post-fracture rehabilitation and treatment.
• Checking for similar or existing applications to find differentiation. Some of the existing apps to look at are MIO Therapy and Goniometer.
• Streamlining functionality and features to make the app efficient and easy to use.
• Integration with native sensors of smartphones (accelerometer, gyroscope, magnetometer, and GPS).
• Creating a messaging system capable of sending simple text, images, video and recorded sound.
• Back-end or server-end development and deployment to the cloud.
• Testing the accuracy of movement and motion detection.

Concept to MVP

• A concept paper showing basic functions and how the smartphone or device add-on can monitor the patient.
• A paper prototype showing workflows and how the motion capture device is set up at the patient’s end can be prepared.
• A basic version of the app showing user interfaces can be commissioned to show the look and feel.
• Preparing the motion sensor capabilities either by using just one of the native smartphone sensors (we recommend GPS or gyroscope for MVP purposes).
• A working version of the app with all the functions working plus access to all usable smartphone sensors. Live testing should be done at this point.
• A roadmap to possible integration with motion capture wearable devices.

Possible causes for delay

• Not bringing in the proper consultants to provide guidance and experience that can be used to improve user experience (e.g., a physiotherapist or a bone fracture patient).
• Not doing regular check-in meetings between stakeholders, decision-makers and developers. Each major milestone should have a sign-off from all parties involved
• The end user is not providing information and support.
• Using a map system that is not complete or reliable. We recommend always using Google Maps or Apple Maps.

Recommendations for a speedy development process

• Have a physiotherapist as a consultant, as they can provide valuable input and real-world experience on what a post-fracture rehabilitation app should do.
• This project can be considered an enterprise-grade app. Developers should have experience in using motion detection technology and know how to integrate and calibrate the app to use a smartphone’s slew of sensors. We recommend outsourcing this project if your in-house developers lack the necessary training and experience.
• If the app is available on both iOS and Android devices, a separate team for each platform should be created, as each platform will require a different approach to using smartphone sensors, integrations with platform maps and the use of messaging systems.
• The app's initial version should be able to utilize the smartphone as a motion capture device. Later versions can incorporate 3rd party add-ons or wearables.
• You and the developer’s standard operating procedure should always require an MVP for thorough testing before developing the final version.
• Since this is an app based on a person’s health, displaying and collecting personal information should comply with Data Privacy laws.
• The testing phase should focus on the accuracy of motion and movement detection, as this is the main service of the app.

Final thoughts

Using motion tracking for medical purposes by using IoT wearables has been around for a few years and FitBit is the best example of a successful IoT adoption. Taking this a step further, the new innovations for post-fracture rehabilitation use the same principle of motion tracking and combine this with video monitoring and messaging to create a complete system. This is a great example of how a successful and useful IoT app can be made even more impactful.
Having surgery to repair broken bones or muscle, tendon and ligament tears is stressful enough and it usually takes weeks or months to recover fully. The lengthy process to full rehabilitation is a long and sometimes painful journey.

Innovations like the IoT-Based Solution to Control Post-Fracture Rehabilitation can allow both patients and physiotherapists to have efficient use of their time and effort.

 

Post-fracture rehabilitation is popular as everyone (knock on wood) is susceptible to bone break and fractures. Suppose you plan to develop your own post-fracture rehabilitation system as an IoT app. Why not partner with a company with a lot of real-world experience when it comes to app development and IoT expertise? Gives us a call or drop a message and get a free consultation regarding your project needs from our qualified representatives!