Experiences of therapists using feedback-based technology to improve physical function in rehabilitation settings: a qualitative systematic review.

Purpose: To synthesise therapist experiences of using feedback-based technology for physical rehabilitation through a systematic review of qualitative studies. Methods: Ten electronic databases were searched up to March 2017. Peer reviewed studies that provided qualitative data that met the inclusion criteria were selected. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme. Relevant text from each study was extracted including quotes and the author's interpretations. Data were imported into NVivo for analysis. Text was coded for content, then categorised using a thematic synthesis approach. Results: The search yielded 50,379 records. Of 340 full text articles assessed for eligibility, 12 publications (10 studies) were included. Themes that emerged relating to therapists' experience of using feedback-based technology in practice were: (1) the benefits of using technology; (2) practicalities of using technology in practice; (3) the need for support; and (4) design to support the use of technology in rehabilitation. Conclusions: Therapists perceive many benefits to using feedback-based technologies in rehabilitation but view it as an addition rather than an alternative to usual therapy. Input from therapists was perceived to be needed for technology to achieve therapeutic benefit. Technology use in practice may be influenced by design limitations or the available support to access and use the technology. Implications for Rehabilitation Therapists perceive technology can be used for benefit as an adjunct to usual therapy with the skilled input of a therapist to assess and monitor patient performance to ensure the "right" quality and quantity of movements for recovery. Technology prescription requires an investment of time and a tailored approach so that its use meets the needs of the individual patient. Support for training, evidence of effectiveness and access to technology is imperative for implementation in practice. Therapists need to work collaboratively with technology developers to improve the design and usability of technologies to better support the rehabilitation process.

Neuropathic pain screening questionnaires have limited measurement properties. A systematic review.

OBJECTIVES: The Douleur Neuropathique 4 (DN4), ID Pain, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), PainDETECT, and Neuropathic Pain Questionnaire have been recommended as screening questionnaires for neuropathic pain. This systematic review aimed to evaluate the measurement properties (eg, criterion validity and reliability) of these questionnaires. STUDY DESIGN AND SETTING: Online database searches were conducted and two independent reviewers screened studies and extracted data. Methodological quality of included studies and the measurement properties were assessed against established criteria. A modified Grading of Recommendations Assessment, Development and Evaluation approach was used to summarize the level of evidence. RESULTS: Thirty-seven studies were included. Most studies recruited participants from pain clinics. The original version of the DN4 (French) and Neuropathic Pain Questionnaire (English) had the most number of satisfactory measurement properties. The ID Pain (English) demonstrated satisfactory hypothesis testing and reliability, but all other properties tested were unsatisfactory. The LANSS (English) was unsatisfactory for all properties, except specificity. The PainDETECT (English) demonstrated satisfactory hypothesis testing and criterion validity. In general, the cross-cultural adaptations had less evidence than the original versions. CONCLUSION: Overall, the DN4 and Neuropathic Pain Questionnaire were most suitable for clinical use. These screening questionnaires should not replace a thorough clinical assessment.