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Eye Tracking Reveals Physical Therapist Decision Making While Evaluating Standing Balance Performance.

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    Physical therapists (PTs) use eye tracking to observe patients during balance rehabilitation. PTs focus most on lower extremities (LE), shifting attention to the head as balance worsens.

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    Area of Science:

    • Biomechanics and Motor Control
    • Rehabilitation Science
    • Human-Computer Interaction

    Background:

    • Physical therapists (PTs) are crucial in balance rehabilitation, relying on visual observation for patient assessment.
    • Eye tracking technology offers objective measurement of PTs' visual attention during clinical tasks.
    • Previous studies analyzed PT visual behavior based on experience, but not patient performance.

    Purpose of the Study:

    • To identify body regions PTs visually focus on during standing balance evaluations.
    • To determine if PTs' visual attention shifts based on observed patient balance performance levels.

    Main Methods:

    • Eleven pairs of older adults and PTs participated in the study.
    • PTs wore eye tracking glasses while observing older adults performing standing balance exercises.
    • Defined areas of interest (head, torso, upper extremities (UE), lower extremities (LE)) were analyzed for visit frequency and duration.

    Main Results:

    • PTs dedicated the most time and had the highest frequency of visual attention to the lower extremities (LE).
    • Conversely, PTs showed the fewest and shortest visual fixations on the upper extremities (UE).
    • As patient balance performance declined, PTs increased visual attention to the head and decreased fixation duration on the torso and LE.

    Conclusions:

    • Lower body strategies are key visual cues PTs use to assess balance.
    • PTs dynamically adjust their visual scanning patterns, rapidly assessing the whole body as balance challenges increase.
    • Findings can inform the development of PT-centric balance assessment tools and training models.