Woebot, a bridge to Artificially Intelligent Physiotherapy?

It is human nature to make tools to make our lives easier. In recent history the development of automation changed lives substantially. Now at first this makes you think of huge clunky machines which lift heavy things onto conveyor belts and performed physical tasks, and this is true. Now refine that concept, add smarter technology and make it smaller and you have a different beast. Now you have something which can learn new tasks and perform complex analysis faster and cheaper than a person.

As this recent article in Wired explains, chatbots are beginning to work in sensitive areas of society such advising refugees, something which you would think only a human would be able to do. Advising a person what to do from a strict list of commands is one thing and never has a chatbot treated a clinical condition before. This line has now been crossed and we are now on a precipice of a dramatic shift in the delivery healthcare.

Woebot was created by Stanford psychologists and AI experts acts as a mental health therapeutic assistant. It provides a therapeutic experience to the users via concepts similar to those used in CBT. Obviously Woebot is not a doctor and is unable to make diagnoses or prescribe medication and advises you to seek ‘real world’ help if it detects a crisis however evidence has shown it to be effective at reducing stress and anxiety.

The technology works through Facebook messenger and asks you questions about your mood. Depending on your answer Woebot follows your answers along a decision tree and offers personal responses. The conversations are tracked and this allows further personalised answers.

The project is based on a previous project called ‘Ellie’ which showed that computers actually make good therapists. Now it is important to say that I am an advocate of technology such as Woebot. It improve the mental health of those unable to access psychiatric healthcare or those who are unlikely to seek help in the first place.

Let’s be honest it is only a matter of time before this sort of tech is changing the landscape of physiotherapy.

Apply this concept to something like exercise prescription and this could alter the future of physiotherapy dramatically. We are already seeing novel telerehab ideas which reduce the need for face to face follow up sessions. Add virtual reality technology into the mix and suddenly a face-to-face consultation is (kind of-)replicated.

(Disclaimer – I’m oversimplifying what we do a physiotherapists in the next part to allow critical discussion)

In a crude sense (I really mean crude sense) some aspects of physiotherapy assessments are either pattern recognition or fitting a particular set of movement restrictions or pain into a diagnostic algorithm. We do this all the time as clinicians, a positive test with a restriction in a movement along with a history will normally tell you what the diagnosis is and therefore your treatment plan. Use the example of an ankle sprain, the assessment can be simple and the rehab can be very specific. Listen to Calibe Doherty and you’ll see what I mean. It is possible with the right combinations of technology could form an advanced form of a PhysioBot. Imagine a Woebot with movement sensors.

Obviously this isn’t happening now and there is a big chance it isn’t happening soon, I haven’t even begun to discuss the ethical implications and the complex clinical reasoning that goes into a physiotherapy assessment and treatment plan or the human contact. It is important we think ahead though.

As a profession we need to embrace this technology and have our say with how it should be used. It is important we don’t see this as a threat or we run the risk of being cast aside, we won’t win in a battle against technology. If we embrace it we will flourish alongside and work together to improve health around the world.