WO2011120121A1

WO2011120121A1 - Physiotherapy animation and rehabilitation management system

Info

Publication number: WO2011120121A1
Application number: PCT/CA2010/000424
Authority: WO
Inventors: Michael Sharp
Original assignee: Collingwood Channel Healthcare Ltd.
Priority date: 2010-03-29
Filing date: 2010-03-29
Publication date: 2011-10-06

Abstract

This invention provides a physical therapy or physiotherapy system for healthcare professionals and remote patients, using interface software with rehabilitation management tools and a library of animated video physical therapy exercises by which a patient's condition can be improved in strength, flexibility, mobility, cardio-vascular activity, cardio- vascular capacity, aerobic activity or capacity, relaxation, occupational skill, weight gain or loss, digestive activity or capacity, brain activity, or mental capacity.

Description

PHYSIOTHERAPY ANIMATION AND REHABILITATION MANAGEMENT SYSTEM

SPECIFICATION

FIELD OF INVENTION

[Para 1] This invention relates to a novel system comprising apparatus and process in the general fields of computer animation and physical therapy , and more specifically to a 3D animation and graphical user interface system for healthcare-directed patient-specific physical therapy and patient rehabilitation management which is distributed via the internet and controlled remotely by a healthcare professional (HCP). "Physical therapy" in this

Specification is meant to include not only traditional physiotherapy treatments but any treatments or exercises that increase or are intended to increase a patient's strength, flexibility, mobility, cardio-vascular activity or capacity, aerobic activity or lung capacity, occupational skill, relaxation, weight gain or loss, digestive activity or capacity, brain activity or mental capacity.

BACKGROUND OF THE INVENTION

[Para 2] Healthcare professionals (HCPs) traditionally communicate personalized physical rehabilitation exercises with paper based drawings or verbal instruction to patients. The limitations of text only instructions contribute to compliance problems, with many patients not correctly applying or remembering sufficient details of their exercises. Also patients tend not to maintain their rehabilitation assignments for the necessary duration due to lack of supervision, feedback, or measurable results. This lack of patient understanding regarding their exercise instructions leads to longer recovery times and less favorable overall outcomes.

[Para 3] Some of the first attempts to provide exercise programming included video recordings of live actors/trainers demonstrating each exercise which are then watched by the user in their home or gym using video playback equipment. More recently computers have been employed to assemble video segments of individual exercises into a customized exercise program package for each user which is then provided on video cassette or DVD format (US 7357756). Note that these methods are restricted to exercises for sports/fitness training and not physiotherapy or rehabilitation which should require the supervision of a healthcare professional for optimal outcome. Also the method used to communicate the exercises, namely videotaping live actors, is costly and requires rehiring actors to generate new exercise segments. Finally, these methods are unable to monitor patient compliance, easily revise the program or add visual effects, or directly manage outcome.

[Para 4] A more recent solution, again in the sports/fitness training market, is a virtual trainer software program (US 20050164833) which allows the user to work with a selected (human) personal trainer who designs exercise sessions which are graphically communicated to the user on a computing device such as a personal data assistant (PDA). The trainer and the user do not have to be at the same location, as the workout may be transmitted by the internet. Exercise segments and gym equipment assignments are assembled from a library available to the personal trainer. One of the key deficiencies of this method is the lack of personal supervision, and the assumption that the person training properly understands how to do the exercises, and is compliant throughout the routine. The software compiles a list of graphical text instructions that while available at hand throughout the workout, still do not provide the level of illustration necessary for proper and safe implementation of the individual exercises.

[Para 5] A recent patent application, "Method for Delivering Exercise Programming by Streaming Animation Video" (US 20080005276) includes software that generates digital animation exercises for sports/fitness training which are posted to a subscriber-only online website. Once subscribed, the user inputs their physical characteristics and training goals online to the service, then directly selects exercises and sets personal goals. Flash animation is then streamed to the subscriber illustrating and narrating their personalized exercise routine. As with the previous example, this is also a virtual coaching environment, wherein the prepackaged animations provided are selectable by the user, but there is no direct consultation with a trainer or health professional in their selection. Also, there is no ongoing means to monitor or govern optimal outcome, as is critical in a clinical rehabilitation setting, even if remotely employed. The issue of who designs the exercise program is somewhat less relevant when one is healthy as the selection of exercises can be tailored to energy level and circumstances; but for optimal rehabilitation and physiotherapy outcome, the healthcare professional should have much more control over the exercise selection process, and supervision over the implementation of these exercises during the recovery period.

SUMMARY OF THE INVENTION

[Para 6] The Physiotherapy Animation and Rehabilitation Management System (PARMS) is designed to provide graphical user interface and database management software for healthcare-directed patient-specific 3D animation physiotherapy exercises and patient rehabilitation management which is distributed via the internet and controlled remotely by the healthcare professional.

[Para 7] An injured patient is referred to a healthcare professional in such fields as physiotherapy, occupational therapy, kinesiology, sports medicine, chiropractic therapy, etc. for treatment. The animation provides a unique opportunity for the healthcare professional to communicate precise and detailed rehabilitation exercises by means of personalized digital animations made available to their patient via the internet. These animations are selected from a digital library of prepared animation exercises and are used by the healthcare professional to design an exercise program for their patient. The patient management aspect of the system provides self-reporting tools that allow the patient to consult with, or report to, the healthcare professional about pain during exercise, correct movements, and program outcomes. The healthcare professional can also monitor patient activity by means of viewing records and patient feedback.

[Para 8] The Physiotherapy Animation and Rehabilitation Management (PARM) System (PARMS) provides a much clearer and more comprehensive understanding of the nature of the rehabilitation exercises required for optimal recovery by combining 3D animations with narration, visual cues and effects along with text. The progress and implementation of the exercise program is monitored and controlled by the healthcare professional so that the patient receives guided care as they recover from their injury. This is unlike sports training animation systems which allow the user to choose which exercise animations they will view, without consulting a qualified trainer or health professional about the appropriateness or health risk of each exercise. One might hypothesize that unsupervised sports training animation systems, and the injuries they might cause, may actually be why there is a need for animation illustration and rehabilitation management systems supervised by healthcare professionals.

[Para 9] Essentially, the invention provides an animated exercise video and physical therapy system for healthcare professionals and remote patients, comprising a system service provider computer server, storing healthcare professional user interface software with rehabilitation management tools and a library of animated video physical therapy exercises, together with remote patient user interface software that displays animated video physical therapy exercises selected by a healthcare professional from the library for a particular patient on the patient's computer in communication with the system service provider computer server. This enables improvement in a patient's condition in strength, flexibility, mobility, cardio-vascular activity , cardio-vascular capacity, aerobic activity , aerobic capacity, relaxation, occupational skill, weight gain, weight loss, digestive activity, digestive capacity, brain activity, or mental capacity. It is preferred that the animated video physical therapy exercises are 3D in appearance, for example, with demonstrator avatars that move to illustrate the exercises from at least two viewpoints. If the camera point of view for the animated video physical therapy exercises moves around an exercise demonstrator during an exercise it can provide enhanced illustration of the exercises. It is useful for the service provider's computer server to record for monitoring by a healthcare professional how often the patient accesses the system and how far through a series of exercises a patient proceeds with the system. Another option would be to equip the remote patient computer is equipped with bio-status sensors for the patient and input lines, to enable bio-feedback review and monitoring during or after a session, by a healthcare professional via the service provider server. BRIEF DESCRIPTION OF THE DRAWINGS

Fig. 1 is a block diagram illustrating how animations are generated, annotated, stored, and utilized by the software, which is then stored on the internet and made accessible to stakeholders and patients.

Fig. 2 is a screen view from a patient's computer showing a sample animated physiotherapy exercise and visual effects.

Fig. 3 is a screen view from a patient's computer showing a sample animated physiotherapy exercise revealing playback controls and different viewing options.

Fig. 4 shows a user's laptop with an animated physiotherapy exercise playing.

Fig. 5 is a screen view from a patient's computer showing a sample animated physiotherapy exercise showing the repetition/steps counter.

DETAILED DESCRIPTION

[Para 10] Figure 1 illustrates how the PARM System 10 is devised and adapted to carry out a physical rehabilitation process on a patient remote from a healthcare professional but within the guidance of the healthcare professional. The system is essentially a personalized exercise and professionally guided physical therapy system comprising the following interfaced modules: a software application (SW) 12, with rehabilitation management tools (RMT) 28, an animation library (DB) 14 which stores animated physiotherapy exercises (APE) 16, together with computer server and communications and display computer hardware and software. In a preferred embodiment, the software application module provides for distribution to a web portal (WP) 22 on the internet (IN) 20. The service provider (SP) 18, by means of its computer portal (CP) 36, stores the current version of the software application (SW) 12, rehabilitation management tools (RMT) 28, and animation library (DB) 14 on the internet (IN) 20. The healthcare professional (HCP) 24 goes to the online web portal (WP) 22, and by means of its login page (LP) 44, is able to access the healthcare professional portion of the web portal secure area (SA) 46. By accessing his secure area of the portal, the healthcare professional is not only able to provide animated illustrations of appropriate exercises for a particular patient, but can also monitor and manage the progress of the patient as the system records how often the patient accesses and proceeds through the prescribed animated video at the patient terminal. Optionally, the patient display computer can be equipped with bio-status sensors and input lines, such as heart-rate and breathing monitors or limb extension sensors. Additionally, at the patient end, camera and video lines could provide feedback to the healthcare professional on a real-time or recorded basis.

[Para 1 1] In order for therapy to begin, the healthcare professional (HCP) 24 accesses their rehabilitation management tools (RMT) 28, and by means of their computer portal (CP) 36, inputs the relevant patient data (PD) 42 in order to select the appropriate animated physiotherapy exercises (APE) 16 from the web portal (WP) 22 in its animation library (DB) 14. The HCP (24) may append additional rehabilitation directions (RD) 48, which are sent with the animated physiotherapy exercises (APE) 16 to the patient (PAT) 26 on their computer portal (36).

[Para 12] The return path may include patient feedback (FB) 38, and patient activity monitoring records (PAM) 40 for consideration and follow up by the HCP (24). The HCP (24) may also send feedback (FB) 38 to the service provider (SP) 18 about suggested refinements or issues with the SW (12).

[Para 13] Animated physiotherapy exercises (APE) 16 may be generated by use of a physiotherapy model (PM) 30, which may be live or digital wireframe, but in the former will need to be recorded by means of video camera (VC) 32. VC 32 data is combined with animation instructions (AI) 34, which may be text or text which is narrated, or both.

[Para 14] Fig. 2 illustrates the view as seen from the screen of a patient's computer portal (CP) 36, and shows a sample animated physiotherapy exercise (APE) 16. The APE 16 portrays an animated demonstrator 50 performing an exercise from at least two viewpoints, in this case using a table of appropriate height as a rehabilitation support 54, and wearing an ankle weight as necessary rehabilitation equipment 56. Also illustrated are two examples of a visual effect 52, which may include any graphical effect that highlights a particular posture, result or body region. In a front view of the animated demonstrator 50, a vertical line demonstrates the proper posture required while performing the selected rehabilitation exercise. The side view of the same exercise highlights the area where one should expect a muscle burn when hyperextending the weighted leg. (note: in the actual animation this is illustrated by a red translucent cloud) Because this image is a paused graphical animation from a computer screen, the play to continue icon 58 is visible in the center of the screen.

[Para 15] Fig. 3 illustrates a similar view as shown in Fig. 2, but illustrating a different animated physiotherapy exercise (APE) 16. In this example, translucent playback controls 72 are visible (may be hidden when not used) and include a play/pause button 60, a start over button 62, a duration bar/slider 64, a duration counter 66, a mute button 68, and a volume slider 70. As in Fig. 2, the animated demonstrator 50 is shown performing an exercise while using a railing as a rehabilitation support 54. In this APE 16, the second viewpoint is a target area closeup 74 as shown.

[Para 16] Fig. 4 illustrates the animated physiotherapy exercise (APE) 16 of Fig. 2 showing the animated demonstrator 50 performing an exercise on the screen of a representative computer portal 36, in this case a portable laptop.

[Para 17] Fig. 5 illustrates a repetitive walking exercise performed by the animated demonstrator 50 where the number of repetitions and steps currently taken are shown by the reps/steps counter 76.

[Para 18] The PARM System 10 may be divided into three general subcategories, namely the software application (SW) 12 including its rehabilitation management tools (RMT) 28; the animation physiotherapy exercises (APE) 16 including how they are generated and where they are stored; and its distribution system, namely any equipment required, and the web portal (WP) 22 on the internet (IN) 20. In summary the software, the animations, and the infrastructure. Any elements named above that require further explanation will now be described within these categories below.

[Para 19] Software: The software application (SW) 12 provides a graphical user interface to play digital video 3D animation clips and audio narration from each animated physiotherapy exercise (APE) 16 on any compatible computer portal (CP) 36. The SW 12 also allows the service provider (SP) 18 to design APEs 16 to meet the medical standards of the healthcare professional (HCP) 24 to whom they are being sent. SW 12 provides rehabilitation management tools (RMT) 28 that allow the HCP 24 to create a customized exercise program, with password protected privacy, and the ability to monitor patient activity by means of viewing records, self-reporting, and patient communications (secure emails). Also the SW 12 allows the patient (PAT) 26 to have password protected privacy and access to personalized 3- D animated physiotherapy exercises customized by their healthcare professional (HCP) 24, including self reporting tools about injury pain, movement, or therapy completion.

[Para 20] Animations: Animated physiotherapy exercises (APE) 16 are generated by either a motion capture video camera (VC) 32 of live actors performing each exercise, or digitally by means of animated physiotherapy models (PM) 30. Individual exercise instructions (AI) 34 are derived from the original written instructions provided to the patient (PAT) 26 by the HCP 24 before the PARM System 10 was designed, but now include unique enhancements of visual and graphical illustration to extend the patient's understanding and motivation for doing their exercises. Also, the HCP 24 may amend the instructions for a patient's (PAT) 26 unique rehabilitation needs. Animated physiotherapy exercises (APE) 16 are labeled by body area, type, and name.

[Para 21 ] APEs 16 are stored in the animation library (DB) which is then uploaded to the internet (IN) 20 when each exercise is approved for inclusion. Basic video data for each APE 16 is edited and narration is created on the SP's 18 computer portal (CP) 36. The animated demonstrator 50 shown in the APEs 16 is a three dimensional representation of a human being, and is fully capable of moving its animated body to perform any physiotherapy exercise possible to a live person. Visual effects 52 enhance the user's understanding of the exercise by, for example, highlighting correct posture, describing where to put a limb, in what direction to move a body part, or where one should feel strain on a muscle. Another feature to help motivate a patient is the provision of a repetition/steps counter 76 for walking exercises, but the counter may be used for any similar repetitive movements.

[Para 22] Infrastructure: By connecting to or uploading (cloud computing) to the internet (IN) 20, stakeholders are able to remotely access the animation library (DB) 14 and utilize the software interface (SW) 12 by means of the secure website portal (WP) 22. Stakeholders go to the login page (LP) 44 on their computer portal (CP) 36, and are granted access to their relevant secure areas SA) 46. Computer portals (CP) 36 are usually a desktop or laptop computer, but also any compatible personal data assistant, large screen cellphone, or netbook may be used. Also, once APEs 16 are downloaded, one may only need a digital projector or other computing display device to view.

[Para 23] The preferred embodiment of the PARM System 10 will now be described.

[Para 24] The PARM System 10 provides internet (IN) 20 based patient (PAT) 26 animated physiotherapy exercise (APE) 16 content and rehabilitation management tools (RMT) 28 for healthcare professionals (HCP) 24. Significant multidisciplinary advancements to the practice of rehabilitative medicine are made possible through the use of personalized 3D animated exercise programs sent over the internet (IN) 20 by the health care professionals (HCPs) 24 to their patients (PAT) 26. These 3D exercise videos replace the paper based exercises currently used by HCPs 24 and represent a great improvement in comprehension and understanding of the exercises by the patients (PAT) 26.

[Para 25] These advancements also include significant improvements for HCPs 24 in the process of patient rehabilitation management. These improvements include being able to manage and monitor patient activity (PAM) 40 over a secure and password protected internet (IN) 20 connection. HCPs 24 can monitor patient watching animated physiotherapy exercises (APEs) 16 in terms of times watched, frequency, duration and specific time of day. They can also review patient reported experience (FB) 38 with the exercises such as pain experienced, ability to perform the exercises, ease of movement, etc. Patient (PAT) 26 alerts and PAT 26 to HCP 24 communications can be facilitated through the secure internet connection and access to the web portal (WP) 22.

[Para 26] Product Overview: The web portal (WP) 22 would be located at a suitable internet domain name address, e.g. xercizplace.com[MAS l ] or exerciseplace.com. The web portal (WP) 22 provides the gateway for an animated physiotherapy exercise (APE) 16 service available to healthcare professionals (HCP) 24 and their patients (PATs) 26. The animation library (DB) 14 is for prescription based use only by those professionals (HCP) 24 with their patients (PAT) 26. Access to the service is by monthly subscription fee. The web portal (WP) 22 is dedicated to supporting patients and healthcare professionals for better outcomes.

Through the web site, healthcare professionals (HCP) 24 access the animation library (DB) 14 of digital video content and create exercise programs for their patients (PATs) 26 using those animations and injury specific rehabilitation directions ( D) 48. By this means, healthcare professionals (HCP) 24 can customize the messaging that accompanies the animated exercises (APE) 16. Patients (PAT) 26 access their personalized exercise program by secure login, then receive program content by email[MAS2] .

[Para 27] The web portal (WP) 22 notifies patients that their[MAS3] physiotherapy program is available by email and links the APE 16 exercises back to the prescribing healthcare professional (HCP) 24, authenticating to each patient (PAT) 26 that these exercises have been sent by their healthcare professional (HCP) 24 for their personalized exercise program.

[Para 28] The library (DB) 14 of animated exercises (APE) 16 is created using 3D animation production techniques that feature exercises with fully synchronized movements from multiple presentation angles. This method creates a uniquely powerful visual illustration of the exercises, unsurpassed in its ability to provide proper instruction and comprehension of the exercise routines. The name and identity of the healthcare professional (HCP) 24 accompanies the animation exercise (APE) 16 content sent to the patients (PAT) 26 so they have complete confidence in using them.

[Para 29] How the Service Works: HCPs 24 log onto the web portal (WP) 22 that allows them to access an library (DB) 14 of professional quality 3D animated physiotherapy exercises (APEs) 16 for the treatment and rehabilitation of injured patients (PAT) 26. The web portal (WP) 22 also contains the previously mentioned patient rehabilitation

management tools (RMT) 28 and reporting facilities for use by the HCP 24. The HCPs 24 enter PAT 26 name/identity data and select or compile a program of APE 16 digital videos that are personalized and specialized for each patient (PAT) 26. The HCP 24 can add customized comments to the APEs 16 if required. APEs 16 are then sent to the PAT 26 over the IN 20 by secure email.

[Para 30] Patients (PATs) 26 will be able to access their personalized exercise[MAS4] program by logging onto the web portal (WP) 22 through a password protected login page (LP) 44 which grants them access to their specific secure area (SA) 46. They will receive email based communications from the web portal (WP) 22. In addition to be able to view their animated exercises (APE) 16, they will also be able to report their progress and experience. This patient reporting will include pain, ability to do the exercises, ease of movement, etc. There may also be positive motivational system based signals for patients (PATs) 26 to encourage them to do their exercises. Patient (PAT) 26 scheduling reminders will also be part of the patient system information.

[Para 31] Benefits of Animated Physiotherapy Exercises (APEs) 16: Healthcare professionals (HCP) 24 traditionally use paper based drawings or verbal instruction to patients (PATs) 26 to communicate personalized exercise programs. The limitations of paper exercise instructions contribute to compliance problems, with many patients (PATs) 26 not correctly applying their exercises. This lack of understanding by the patient (PAT) 26 regarding their exercise instructions leads to longer recovery times and less favorable overall outcomes.

[Para 32] The internet (IN) 20 has become a visually oriented medium. The overwhelming success of video content sites such as You Tube demonstrates the public's growing preference for viewing and consuming information in the form of short video or animations. Because internet (IN) 20 infrastructure and computer hardware (CP) 36 are already in place, securely viewing videos or animation over the internet (IN) 20 is easy to do. The PARM System 10 uses leading edge 3D animation with multiple camera angles to enhance the visual experience, making it a highly effective medium for communication. Additional

enhancements include visual effects to show the exact area of the body where the effects of the exercise are to be felt, or coach the patient (PAT) 26 by highlighting the specific postures or movements required by each exercise. Exercise animations (APEs) 16 can be replayed or paused to check positioning, making them an ideal learning medium for patients (PATs) 26. Internet based videos and animations are a proven medium of communication with great potential for revolutionizing how exercise instructions are administered in clinical practice. This makes it of key importance to document the use of animation based exercise instructions to fully understand their role and impact in patient care, in a daily practice environment. The PARM System [MAS5] provides a unique opportunity for various healthcare professionals and organizations to collaborate a) in providing optimal physical exercises to improve the condition of individual patients, b) in pilot programs and future development of the system and the services enabled; and c) in running and monitoring clinical trials. PARMS provides a unique therapy platform for patients that can make far-reaching improvements to both their physiogomy and their loyalty to the healthcare professional providing the guidance.

[Para 33] The system could aid in preventing falls among seniors through exercise education and improved fitness, improve access to care, and reduce care delivery costs.

[Para 34] Industry research indicates that only 34 to 62% of patients undergoing

physiotherapy correctly apply their exercise programs. The PARMS system will enable its designers to monitor and improve the effectiveness of the service by analyzing patient activity with the system and by conducting clinical research in conjunction with academic health care institutions and health care authorities. This process of ongoing monitoring, improvement and validation of the effectiveness of the PARMS exercises, a process that is enabled by the interactive data exchange inherent to PARMS will enable growth of the PARM system as other recognized healthcare professionals and institutions take note and subscribe or provide additional specialized kinds of guidance remotely to patients.

[Para 35] The PARM System [MAS6] is essentially and preferably an internet (IN) 20 based service that features high quality animated physiotherapy exercises (APEs) 16 for the professional healthcare marketplace. The system enables relationship-building among patients (PATs) 26, healthcare professionals (HCPs) 24 and the healthcare organizations that support them. The PARMS web portal (WP) 22 provides a library (DB) 14 of 3-D animation exercises (APEs) 16 that are prescribed by healthcare professionals (HCPs) 24 for individual patient treatment care and injury rehabilitation. These online animated exercise programs are designed to improve patient access to treatment, compliance and recovery. The exercises and supporting web portal (WP) 22 utilities deliver professional quality communications tools to enhance patient relationships and optimal care.

[Para 36] Further advantages of the PARM System 10 include, but are not limited to the fact that healthcare professionals (HCPs) 24, by means of their involvement in the exercise selection and augmentation process have much better control over the quality of information provided to their patients (PATs) 26 than the old written or diagrammed prescription regime. Outcome monitoring & management is in the hands of healthcare professional (HCP) 24, unlike sports video/animation providers who are merely selling a product instead of provide a professionally credentialed and healthcare authority sponsored service. Another improvement over sports training products is that access to animation programs is by secure web portals, where APEs 16 are sent by streamed to the user, which makes them universally accessible over the internet. Also, the software application is stored online (cloud computing), while patient data is securely stored on protected servers with the HCP 24. Finally, the generation of 3D animation includes live action motion capture and digital animation techniques, the latter allowing for rapid and seamless revision and economical expansion.

[Para 37] The foregoing description of the preferred apparatus and method of

implementation should be considered as illustrative only, and not limiting. Other animation techniques and other networking platforms may be employed towards similar ends. Various changes and modifications will occur to those skilled in the art, without departing from the true scope of the invention as defined in the above disclosure, and the following claims.

Claims

PHYSIOTHERAPY ANIMATION AND REHABILITATION MANAGEMENT SYSTEM CLAIMS

We Claim:

An animated exercise video and physical therapy system for healthcare professionals and remote patients, comprising: a) a system service provider computer server, storing healthcare professional user interface software with rehabilitation management tools and a library of animated video physical therapy exercises; and b) remote patient user interface software that display animated video physical therapy exercises selected by a healthcare professional from the library for a particular patient on the patient's computer in communication with the system service provider computer server; by which a patient's condition can be improved in strength, flexibility, mobility, cardiovascular activity , cardio- vascular capacity, aerobic activity , aerobic capacity, relaxation, occupational skill, weight gain, weight loss, digestive activity, digestive capacity, brain activity, or mental capacity.

2. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which the animated video physical therapy exercises are 3D in appearance.

3. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which the animated video physical therapy exercises comprise demonstrator avatars that move to illustrate the exercises.

4. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which healthcare professional-selected, patient-specific video portrays a demonstrator performing physical therapy exercises from at least two viewpoints.

5. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which a point of view in the animated video physical therapy exercises moves around an exercise demonstrator to provide enhanced illustration of the exercises.

6. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which communication between the service provider's computer server and the remote patient's computer is via the internet.

7. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which the service provider's computer server is accessible at a web portal.

8. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which the patient user software provide self-reporting tools about injury pain, movement, or therapy completion.

9. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which the service provider's computer server records for monitoring by a healthcare professional how often the patient accesses the system and how far through a series of exercises a patient proceeds with the system.

10. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which the remote patient computer is equipped with bio-status sensors and input lines, to enable bio-feedback review and monitoring by a healthcare professional.

11. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which the healthcare professional user software provides for input of relevant patient data in order to appropriately select animated video physical therapy exercises.

12. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which the healthcare professional user software provides for feedback by a healthcare professional to a service provider about issues with the system.

13. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1, in which a library of animated video physical therapy exercises is combined with text instructions.

14. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which animated video of physical therapy exercises is combined with narrated instructions.

15. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 1 , in which a software application provides a graphical user interface to play digital video 3D animation clips and audio narration.

16. The animated exercise video and physical therapy system for healthcare professionals and remote patients of Claim 2, in which: a) the animated video physical therapy exercises comprise demonstrator avatars that move to illustrate the exercises from multiple viewpoints; b) communication between the service provider's computer server and the remote patient's computer is via the internet, with the service provider's computer server is accessible at a web portal; c) the patient user software provides self-reporting tools, and the service provider's computer server records for monitoring progress by a patient by a healthcare professional; d) the healthcare professional user software provides for input of relevant patient data in order to appropriately select animated video physical therapy exercises: e) the library of animated video physical therapy exercises is combined with narrated instructions.