Virtual rehabilitation keeps patients moving at home

Michael Barnett, physical therapist assistant, Musculoskeletal Center Unit (Verdi 4 East), helped hip replacement patient Kathy Boskello perform exercises using the new Virtual Exercise Rehabilitation Assistant (VERA). In addition to having in-person therapy, Boskello will use VERA at home for the next several weeks.

When Kathy Boskello left Yale New Haven Hospital after hip replacement surgery last month, she had a rehabilitation coach waiting for her at home.

The coach's name is VERA, short for Virtual Exercise Rehabilitation Assistant – a digital program that guides patients through prescribed exercises after joint replacement. YNHH is the first Connecticut hospital to use the VERA in-home program, together with in-person physical therapy.

With VERA, the patient sits or stands in front of a 3D camera and monitor while an onscreen avatar demonstrates the exercises prescribed for that patient. As the patient performs each exercise, the 3D camera detects, measures and analyzes his or her movements and provides feedback. Physical therapists, physicians and other clinical staff can remotely view the patient's movements and receive reports about VERA exercise sessions. Therapists can discuss patients' progress with them by phone or through VERA's tele-health capability.

Seventeen patient rooms on the Verdi 4 East Center for Musculoskeletal Care unit are equipped with VERA, and some patients will have VERA installed at home before surgery.

"There's nothing like the person-to-person contact with a physical therapist, but VERA did help me prepare," said Boskello, who used the system for a week before her surgery. "I was able to get more comfortable with the equipment and the exercises."

She will continue using the system for about six weeks after discharge. With VERA, patients can perform their exercises at home several times a day, versus just once a day at a rehabilitation facility or with a visiting therapist.

"Exercise is key to improving patients' function after surgery," said Mary O'Connor, MD, director, Center for Musculoskeletal Care, YNHH and Yale School of Medicine. "VERA does not replace in-person therapy, but enhances it, by helping patients perform the exercises prescribed for them at home, at their convenience. It's another way of engaging patients in their care and improving their outcomes."