Technologies in Home-Based Digital Rehabilitation: Scoping Review.

BACKGROUND: Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients' needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. OBJECTIVE: In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. METHODS: The scoping review followed the framework of Arksey and O'Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. RESULTS: A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches but has not led to the development of new technologies. CONCLUSIONS: Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.

The Influence of Mobile Device Type on Camera-Based Monitoring of Neck Movements for Cervical Rehabilitation.

We developed a mobile application for cervical rehabilitation that uses a non-invasive camera-based head-tracker sensor for monitoring neck movements. The intended user population should be able to use the mobile application in their own mobile device, but mobile devices have different camera sensors and screen dimensions that could affect the user performance and neck movement monitoring. In this work, we studied the influence of mobile devices type on camera-based monitoring of neck movements for rehabilitation purposes. We conducted an experiment to test whether the characteristics of a mobile device affect neck movements when using the mobile application with the head-tracker. The experiment consisted of the use of our application, containing an exergame, in three mobile devices. We used wireless inertial sensors to measure the real-time neck movements performed while using the different devices. The results showed that the effect of device type on neck movements was not statistically significant. We included the sex factor in the analysis, but there was no statistically significant interaction between sex and device variables. Our mobile application proved to be device-agnostic. This will allow intended users to use the mHealth application regardless of the type of device. Thus, future work can continue with the clinical evaluation of the developed application to analyse the hypothesis that the use of the exergame will improve therapeutic adherence in cervical rehabilitation.

Camera-Based Monitoring of Neck Movements for Cervical Rehabilitation Mobile Applications.

Vision-based interfaces are used for monitoring human motion. In particular, camera-based head-trackers interpret the movement of the user's head for interacting with devices. Neck pain is one of the most important musculoskeletal conditions in prevalence and years lived with disability. A common treatment is therapeutic exercise, which requires high motivation and adherence to treatment. In this work, we conduct an exploratory experiment to validate the use of a non-invasive camera-based head-tracker monitoring neck movements. We do it by means of an exergame for performing the rehabilitation exercises using a mobile device. The experiments performed in order to explore its feasibility were: (1) validate neck's range of motion (ROM) that the camera-based head-tracker was able to detect; (2) ensure safety application in terms of neck ROM solicitation by the mobile application. Results not only confirmed safety, in terms of ROM requirements for different preset patient profiles, according with the safety parameters previously established, but also determined the effectiveness of the camera-based head-tracker to monitor the neck movements for rehabilitation purposes.

Validity and reliability of instruments aimed at measuring Evidence-Based Practice in Physical Therapy: a systematic review of the literature.

RATIONALE, AIMS AND OBJECTIVES: Our goal is to compile and analyse the characteristics - especially validity and reliability - of all the existing international tools that have been used to measure evidence-based clinical practice in physiotherapy. METHODS: A systematic review conducted with data from exclusively quantitative-type studies synthesized in narrative format. An in-depth search of the literature was conducted in two phases: initial, structured, electronic search of databases and also journals with summarized evidence; followed by a residual-directed search in the bibliographical references of the main articles found in the primary search procedure. The studies included were assigned to members of the research team who acted as peer reviewers. Relevant information was extracted from each of the selected articles using a template that included the general characteristics of the instrument as well as an analysis of the quality of the validation processes carried out, by following the criteria of Terwee. RESULTS: Twenty-four instruments were found to comply with the review screening criteria; however, in all cases, they were found to be limited as regards the 'constructs' included. Besides, they can all be seen to be lacking as regards comprehensiveness associated to the validation process of the psychometric tests used. CONCLUSION: It seems that what constitutes a rigorously developed assessment instrument for EBP in physical therapy continues to be a challenge.