JMIR Rehabilitation and Assistive Technologies

This viewpoint paper explores the dynamic intersection of physiotherapy and digital health technologies (DHTs) in enhancing the care of people with cystic fibrosis (pwCF), in the context of advancements such as highly effective modulator therapies (HEMTs) that are enhancing life expectancy and altering physiotherapy needs. The role of DHTs, including telehealth, surveillance, home monitoring, and activity promotion, has expanded, becoming crucial in overcoming geographical barriers and accelerated by the recent pandemic. Physiotherapy, integral to CF care since 1946, has shifted towards patient-centred approaches, emphasising exercise training and a physically active lifestyle. The reduction in inpatient admissions due to HEMTs has led to increased homecare and virtual consultations, and DHTs have revolutionised service delivery, offering flexibility, self-management, and personalised care options, however there is a need to comprehensively understand user experiences from both people with CF (pwCF) and physiotherapists. The paper highlights the essential exploration of user experiences to facilitate clinician adaptation to the digital requirements of modern clinical management, ensuring equitable care in the "Future Hospitals" arena. Identifying research gaps, the paper emphasises the need for a thorough evaluation of DHT utilisation in CF physiotherapy education, training, and self-monitoring, as well as the experiences of pwCF with virtual consultations, self-monitoring and remote interventions. Online group exercise platforms address historical challenges relating to infection control, but necessitate comprehensive evaluations of user experiences and preferences. Future-proofing DHTs within the physiotherapy management of CF demands a shift towards full integration, considering stakeholder opinions and addressing barriers. While DHTs have the potential to extend physiotherapy beyond the hospital, the paper stresses the importance of understanding user experiences, addressing digital poverty, and working towards more equitable healthcare access. A flexible approach in the 'future hospital' is advocated, emphasising the need for a nuanced understanding of user preferences and experiences to optimise the integration of DHTs in CF care.

Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments available to counter cognitive decline have only modest effects, with significant side effects. A nonpharmacological treatment that has received considerable attention is computerized cognitive training (CCT), which aims to maintain or improve cognitive functioning through repeated practice in standardized exercises. CCT allows for more regular and thorough training of cognitive functions directly at home, which represents a significant opportunity to prevent and fight cognitive decline. However, the presence of assistance during training seems to be an important parameter to improve patients’ motivation and adherence to treatment. To compensate for the absence of a therapist during at-home CCT, a relevant option could be to include a virtual assistant to accompany patients throughout their training.

Lower limb amputation (LLA) impacts physical activity (PA) participation and quality of life (QoL). To minimize the effects of these challenges, LLA survivors need to have opportunities to engage in appropriately tailored rehabilitation throughout their lives. However, in Sri Lanka, where a 3-decade civil war resulted in trauma-related LLA among young male soldiers, access to rehabilitation was limited to the immediate postinjury period. Developing rehabilitation interventions for these veterans requires an understanding of their current health status and rehabilitation perceptions.

People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people’s request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals.

People who survive a stroke, in many cases require upper-limb rehabilitation (ULR), which plays a vital role in stroke recovery practices. However, rehabilitation services in the Global South are often not affordable or easily accessible. For example, in Bangladesh, the access to and use of rehabilitation services is limited and influenced by cultural factors and patient’s everyday lives. In addition, while wearable devices have been used to enhance ULR exercises to support self-directed home-based rehabilitation, this has primarily been applied in developed regions and is not common in many Global South countries due to potential costs and limited access to technology.

The Box and Block Test is a clinical tool used to measure hand dexterity. It serves as an assessment for tracking disease progression or the success of therapy, often benefiting elderly individuals and those with neurological conditions. Digitizing the measurement of hand function may improve the quality of data collection. We have developed and validated a prototype that digitizes this test a prototype that digitizes this test by automatically measuring the time and determining and displaying the test result – the digital Box and Block Test (dBBT).

Rehabilitation supports the affected individual and their caregivers in managing the health condition and its associated symptoms, altering the environment to accommodate needs, adapting tasks for safe and independent performance, facilitating self-management, and using assistive devices and technologies. JMIR Rehabilitation and Assistive Technologies focuses on pragmatic yet rigorous and impactful science that reports on the development, implementation, and evaluation of health innovations and interventions as well as emerging technologies in the field of rehabilitation.

Physical activity (PA) represents a low-cost and readily available means of mitigating multiple sclerosis (MS) symptoms and alleviating the disease course. Nevertheless, persons with MS engage in lower levels of PA than the general population.

Older adults face barriers to specialty care, such as occupational therapy (OT), and these challenges are worse for rural older adults. While in-home video telehealth may increase access to OT, older adults’ health- and technology-related challenges may necessitate caregiver assistance.

The acquisition of handwriting skills is essential for a child’s academic success, self-confidence, and general school performance. Nevertheless, an estimated 5% to 27% of children face handwriting challenges, where the ability to modulate pressure on the pencil and lead on the paper is a key motor component.

Digital interventions provided through smartphones or the internet that are guided by a coach have been proposed as promising solutions to support the self-management of chronic conditions. However, digital intervention for poststroke self-management is limited; we developed the interactive Self-Management Augmented by Rehabilitation Technologies (iSMART) intervention to address this gap.

Youth (age 15-24 years) with and without disability are not adequately represented enough in exercise research due to a lack of time and transportation. These barriers can be overcome by including accessible web-based assessments that eliminate the need for on-site visitations. There is no simple, low-cost, and psychometrically sound compilation of measures for physical fitness and function that can be applied to youth with and without mobility disabilities.