JMIR Rehabilitation and Assistive Technologies

Educational multimedia is a cost-effective and straightforward way to administer large-scale information interventions to patient populations in musculoskeletal health care. While an abundance of health research informs the content of these interventions, less guidance exists about optimizing their design.

Work burden increases for physiotherapists in the primary health care sector as the prevalence of musculoskeletal disorders (MSDs) increases. Digital health technologies (DHTs) are proposed as a viable solution to secure the sustainability of the health care system and have shown promising results in a range of conditions. However, little is known about use of DHTs among physiotherapists in the primary health care sector in Norway.

Globally, one in three people live with health conditions that could be improved with rehabilitation. Ideally this is provided by trained professionals delivering evidence based dose, intensity and content of rehabilitation, for optimal recovery. The widely acknowledged inability of global healthcare providers to deliver recommended levels of rehabilitation, creates an opportunity for technological innovation. Design processes that lack close consideration of users’ needs and budgets, however, mean that many rehabilitation technologies are neither useful, nor used. To address this problem our multi-disciplinary research group have established a co-creation centre for rehabilitation technology that places the end user at the centre of the innovation process.

Light wearable robots have the potential to assist older adults with mobility impairments in daily life by compensating for age-related decline in lower extremity strength. Physiotherapists may be the first point of contact for older adults with these devices.

Low back pain (LBP) is a significant public health problem that can result in physical disability and financial burden for the individual and society. Physical therapy is effective for managing LBP and includes evaluation of posture and movement, interventions directed at modifying posture and movement, and prescription of exercises. However, physical therapists have limited tools for objective evaluation of low back posture and movement and monitoring of exercises, and this evaluation is limited to the time frame of a clinical encounter. There is a need for a valid tool that can be used to evaluate low back posture and movement and monitor exercises outside the clinic. To address this need, a fabric-based, wearable sensor, Motion Tape (MT), was developed and adapted for a low back use case. MT is a low-profile, disposable, self-adhesive, skin-strain sensor developed by spray coating piezoresistive graphene nanocomposites directly onto commercial kinesiology tape.

Stroke is a leading cause for long-term disability, requiring both inpatient and outpatient rehabilitation and self-training in the home environment. Technology-based tools are gradually gaining acceptance as additional and suitable options for extending the rehabilitation process. While the experiences of persons living with stroke, therapists, and informal caregivers with respect to technology use have already been investigated in other countries, this topic is underexplored in the Swiss context.

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).