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Journal Description

JMIR Rehabilitation and Assistive Technologies (Editor in Chief: Sarah Munce, PhD) is a PubMed/PubMed Central, SCOPUS, DOAJ, Web of Science, Sherpa/Romeo and EBSCO/EBSCO Essentials indexed journal that focuses on readable and applied science that reports on the development, implementation, and evaluation of health innovations and emerging technologies in the field of rehabilitation.

JMIR Rehabilitation and Assistive Technologies received an inaugural Journal Impact Factor of 3.0 according to the latest release of the Journal Citation Reports from Clarivate, 2025.

JMIR Rehabilitation and Assistive Technologies received a CiteScore of 5.7 (2024), placing it in the 93rd percentile (#11 of 165) as a Q1 journal in the field of Rehabilitation.

 

Recent Articles:

  • Source: AdobeStock; Copyright: 24K-Production; URL: https://stock.adobe.com/uk/images/disabled-man-on-wheelchair-with-his-dog-on-a-trip-in-nature/451730307; License: Licensed by the authors.
    Spinal Cord Injury Rehabilitation

    Feb 11, 2026

    Design Recommendations for Virtual Reality–Based Upper Limb Exercises From People With Tetraplegia and Spinal Cord Injury Rehabilitation Specialists: Focus...

    Authors List:

    Abstract:

    Background: The global incidence of spinal cord injury (SCI) is between 10 and 80 new cases per million people each year. This equates to between 250,000 and 500,000 injuries worldwide per year. In the United Kingdom, approximately 4400 people per year sustain an SCI. People with tetraplegia report upper limb function as their highest priority for improvement after SCI. Using immersive virtual reality (VR) headsets, physical rehabilitation exercises can be completed in engaging digital environments. Immersive VR therefore has the potential to increase the amount of therapy undertaken, leading to improvements in arm and hand function. There is little evidence supporting immersive VR as exercise in SCI, especially while patients with SCI are undergoing acute rehabilitation. In SCI research, co-design of new interventions is not a widely adopted approach, yet people with tetraplegia want to contribute with their expert knowledge on their experiences of SCI. Objective: This study aims to explore the lived experiences of people with tetraplegia and specialist SCI therapists related to acute upper limb rehabilitation and identify design considerations for VR-based interventions targeting the upper limb. Methods: We conducted 7 online focus groups using Microsoft Teams: 4 with people with tetraplegia (n=15; age range, 36-65 years) and 3 with occupational therapists and physiotherapists specializing in SCI rehabilitation (n=11). Participants were asked to discuss their experiences and expertise about acute SCI upper limb rehabilitation and their opinions and ideas on the use of VR for upper limb rehabilitation. The transcripts were analyzed using content analysis, enabling the proposition of design characteristics of a VR-based intervention for upper limb exercise. Results: The study identified 5 major themes describing the clinical features, treatment, and recovery of people with SCI during the acute stage of SCI, their motivations for participating in therapy, and suggestions for the design of a VR intervention in treating the upper limbs following SCI. Conclusions: The themes identified in this study allow the elicitation of software requirements for a bespoke immersive VR platform for upper limb rehabilitation following SCI. They can also contribute to a better understanding of the advantages of using VR as an adjunct to upper limb rehabilitation. Additionally, participants used their expertise to suggest factors that would enable the development of a usable and effective intervention, as well as identifying potential pitfalls and software features to avoid during intervention development. These findings can be used to design accessible VR applications for use by people with tetraplegia and their therapists.

  • Source: Freepik; Copyright: freepik; URL: https://www.freepik.com/free-photo/side-view-woman-holding-tablet_34653892.htm; License: Licensed by JMIR.
    Theme Issue: Participatory Methods in...

    Feb 4, 2026

    Voice-Assisted Technology for People With Parkinson's Disease Experiencing Speech and Voice Difficulties: Co-Designing Solutions Using Design Thinking

    Authors List:

    Abstract:

    Background: While smart speakers are emerging as a novel health care technology, people with Parkinson's Disease (PwPD) and speech and language therapists (SaLTs) have reported difficulties using smart speakers with speech and voice impairments in research. To date, PwPD have identified frustration with having to repeat themselves to be understood, devices timing out before they had finished speaking, and being unable to have a conversation with smart speakers. SaLTs have reported technical and practical challenges in implementing voice-assisted technology tools. Both PwPD and SaLTs indicated a lack of knowledge about what smart speakers could do, as well as concerns about privacy and the listening nature of the devices. Objective: This study aims to co-design solutions that support the use of smart speakers for speech and voice difficulties experienced by PwPD. Methods: Based on the Design Thinking framework, a multistage design process was conducted, involving a lay steering group and 2 online co-design workshops. Twenty participants, including PwPD, carers, SaLTs, design and technology experts, and third-sector staff, collaborated during the co-design workshops. The ideate phase included brainstorming and ranking, and conventional content analysis was used to specify prototypes. Results: Two main prototypes were created: (1) education and guidance, including privacy and therapeutic usage guides for PwPD and SaLTs to address troubleshooting and delivery considerations; and (2) new speech and language therapy (SLT)–specific features for smart speakers. Participants provided feedback on their experiences of co-design, highlighting feeling valued, the balance of perspectives, and making improvement suggestions. Feedback aligned with the UK standards for public involvement. Conclusions: Smart speakers could enhance accessibility, therapy engagement, and long-term speech outcomes, offering scalable, cost-effective solutions to support SLT services, patient independence, and reduced service demand. Smart speaker solutions with a SLT focus enable PwPD to self-manage speech and voice difficulties at home and reinforce therapy gains between clinic visits. Co-designed with users, these prototypes are intended to address health disparities and relieve pressure on SLT services, offering a scalable and sustainable solution that enhances efficiency and supports ongoing rehabilitation within health care systems.

  • Source: Image created by the authors; Copyright: The Authors; URL: https://rehab.jmir.org/2026/1/e79553/; License: Creative Commons Attribution (CC-BY).
    Assistive Technologies

    Feb 2, 2026

    Blockchain-Based Mobile App for Digital Identification of Older Adults in Rural Peru: Design and Usability Evaluation Study

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    Abstract:

    Background: Older adults in rural areas of Peru encounter many challenges in accessing critical public services sections, such as public health services, education services, and social assistance public services, due to low levels of digital literacy, lack of technology access, and no formalized and secure identification. This inhibits entry into digital health, education, and social assistance systems and increases their risk of vulnerability and social exclusion. Objective: To design a blockchain technology-based mobile application architecture to help facilitate a secure and inclusive digital ID for older adults in rural areas of Peru to access vital services digitally with a decentralized and privacy-friendly solution. Methods: This study followed the Design Thinking steps. There are five steps in Design Thinking, which include: Empathize, Define, Ideate, Prototype, and Evaluate. A total of 16 older adults (61 - 85 years of age) were interviewed to determine the usability barriers and trust issues with mobile technology, which will be used to define functional and non-functional requirements. Those requirements were created based on the interviews. The primary features that the target population valued are: blockchain authentication, assisted registration, multilingual, and user-friendly. The features were prioritized and prototyped in Figma. The architecture of the application was developed using the C4 model and accounted for sequential development and ensured scalability, modularity, and decentralization. Usability was assessed quantitatively by administering the System Usability Scale (SUS) to the same 16 participants after they had interacted with the prototype. Results: The average SUS score was 60.78 (SD = 13.68), this is acceptable usability. The main issues identified were the lack of skills to navigate digital interfaces, poor trust that the data was secure, and challenges with people with disabilities' ability to access the service. Participants provided high ratings for the assisted registration system and notifications. The modular architecture of the system, based on blockchain, showed a great deal of potential to scale and include more people. The prioritization matrix identified that, for adoption, features must contain good design, be multilingual, and require secure authentication. Conclusions: The blockchain-based mobile application model we propose offers a viable technical and socially inclusive model for the secure digital identification of seniors in under-service contexts. Usability tests suggested that the solution was perceived as secure, usable and appropriate for this target population. While not fully deployed, our prototypes and architecture provide a good starting point for future deployment. The findings in this study can contribute to efforts to facilitate digital inclusion, access to services, and respect for people's autonomy in identity management systems for vulnerable people.

  • Source: Image created by the authors; Copyright: The Authors; URL: https://rehab.jmir.org/2026/1/e80607; License: Licensed by the authors.
    Emerging Technologies for Rehabilitation

    Jan 30, 2026

    Leveraging Large Language Models for Early Detection of Anomaly Work Injury Cases: Data-Driven Approach to Rehabilitation Efficiency

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    Abstract:

    Background: Large language model (LLM) have demonstrated potential in automating the analysis of unstructured clinical data, yet their application in rehabilitation trigae for work injury cases remains underexplored. Objective: We aimed to evaluate the performance of an LLM-assisted approach for the rapid identification of anomalous rehabilitation cases of work injury, aiming to enhance scalability and precision in case management. Methods: We retrospectively analysed 110,346 de-identified work-injury cases between 2001 year, and 2024 year from a leading rehabilitation coordination company in Hong Kong, representing approximately 20% of all work injury incidents in the region. Large Language Models were used to estimate the expected duration of recovery based on free-text injury descriptions. Cases in which the actual number of medically certified sick leave days exceeded the LLM-predicted maximum were classified as anomalies. Results: The LLM-assisted method achieved high accuracy, with GPT-4o achieving over 73% accuracy in normality classification and 79% accuracy in all dataset detection, outperforming comparator models. The model maintained high accuracy across subgroups and demonstrated reliable extraction of information from free-text notes. Conclusions: The proposed method demonstrated robustness when evaluated on a large-scale dataset with a bimodal age distribution. This study highlights the potential of LLMs to transform rehabilitation workflows by automating anomaly detection at scale. The method also shows promise in tailoring rehabilitation strategies to age-specific needs and leveraging LLM tools for efficient case management. However, a key limitation is that the dataset includes only injury cases from a single geographic region, which may limit the generalizability of the findings to other populations or healthcare systems. Clinical Trial: NA

  • Source: Freepik; Copyright: Freepik; URL: https://www.freepik.com/free-photo/full-shot-man-with-gym-ball-home_13161071.htm; License: Licensed by JMIR.
    Telerehabilitation

    Jan 27, 2026

    Telerehabilitation Trends in Australian Physiotherapy and an Exploration of Factors That Influence Use After COVID-19 Restrictions: Qualitative Content Analysis

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    Abstract:

    Background: Telerehabilitation is a safe and effective means of delivering physiotherapy services, but implementation in clinical practice has not been widespread. Objective: To explore the shifts in telerehabilitation use throughout the COVID-19 pandemic and the key factors that influenced telerehabilitation caseload after restrictions were eased. Methods: Between September and November 2023, physiotherapists practicing in Australian private practice, hospital outpatient or community settings completed an online survey. Data were collected regarding participants’ use of telerehabilitation prior to, during, and after the COVID-19 pandemic restrictions to in-person physiotherapy. Qualitative content analysis of open text questions was performed to garner more nuanced information about the use of telerehabilitation in clinical practice and quantitative data were analysed descriptively. Results: The proportion of participants using telerehabilitation rose from 30% (44/148) prior to the pandemic, to 94% (138/147) when restrictions to in-person physiotherapy were in place. Although 82% of the sample (118/144) continued to deliver telerehabilitation after COVID-19 restrictions were eased, telerehabilitation accounted for only 14% of total caseload. Exploratory analyses suggest that despite increased confidence, satisfaction and perceptions about effectiveness of telerehabilitation, reduced patient demand, physiotherapists’ perceptions about patient preference for in-person consultations and the perception that in-person physiotherapy is easier influence use of telerehabilitation in the post-COVID era. Conclusions: Despite increased uptake during the pandemic, telerehabilitation caseload after restrictions were eased was low. Physiotherapists’ perceptions about telerehabilitation in clinical practice remains a substantial barrier to sustained adoption.

  • AI-generated image, in prompt to "Photorealistic 4:3 image of a middle-aged woman with fibromyalgia performing guided neck exercises while wearing an unbranded immersive VR headset, with subtle medical HUD overlays conveying reduced pain, kinesiophobia and central sensitization, increased cervical ROM and adherence, and sustained functional improvement." (generator: ChatGPT; requestor: Juan Pablo Hervás Pérez). Source: Image created by ChatGPT; Copyright: N/A (AI-generated image); URL: https://rehab.jmir.org/2026/1/e81158; License: Public Domain (CC0).
    Cognitive and Neurorehabilitation

    Jan 23, 2026

    Therapeutic Use of Virtual Reality for Patients With Fibromyalgia and Chronic Neck Pain: Randomized Controlled Trial

    Authors List:

    Abstract:

    Background: Fibromyalgia (FM) causes widespread pain, fatigue, and cognitive abnormalities. Cervical pain is a com-mon and debilitating symptom. This study evaluates the effectiveness of virtual reality (VR) as a treatment for chronic cervical pain experienced by FM patients. Objective: In this study, we aimed to evaluate the effectiveness of VR as a therapeutic option for neck pain in pa-tients with FM. We hypothesized that VR could decrease cervical pain and kinesiophobia and increase ROM, facilitating improvements in quality of life and adherence to treatment. Methods: A single-blind randomized clinical trial was conducted. Fifty-four women were randomly assigned to three groups: G1 (VR + cervical mobility exercises), G2 (cervical mobility exercises), and CG (control group). Therapy was administered twice a week for 4 weeks. Variables such as disease impact, quality of life, kine-siophobia, pain, range of motion, fatigue, and treatment adherence were measured. Results: The mean age of the participants was 54.26 (7.7), and they were overweight, with a mean BMI of 28.7 (7.8). The mean VAS value was 6.72 (1.8). The baseline values for age, BMI, VAS, algometric measures, and func-tional capacity (measured using the Timed Up and Go test, cervical rotation, and lateral displacement) were similar across the three groups. After therapy, the control group showed no significant improvements, while both therapy groups did show improvements. Significant differences were found between G1 and G2/G3 but not between G2 and G3. These differences remained at the one-month follow-up. Conclusions: Our study suggests that cervical mobility exercises alone may not significantly improve pain relief and functional capacity among FM patients compared to a placebo. However, combining VR with these exer-cises leads to significant improvements. VR may enhance the effects of neck physical therapy in the context of FM. Clinical Trial: This study was registered at ClinicalTrials.gov NCT05933941.

  • Source: Freepik; Copyright: freepik; URL: https://www.freepik.com/free-photo/medium-shot-woman-stretching-desk_43545674.htm; License: Licensed by JMIR.
    Telerehabilitation

    Jan 20, 2026

    Linguistic Validation and Cross-Cultural Adaptation of the Shoulder Telehealth Assessment Tool for Filipino Patients with Musculoskeletal Shoulder Condition:...

    Authors List:

    Abstract:

    Background: Telerehabilitation has been widely adapted to meet the growing rehabilitation demand, but is often limited by unstable internet connection, poor audiovisual resolution, and difficult virtual assessment. The Shoulder Telehealth Assessment Tool(STAT) was developed to address these limitations. Objective: This study aimed to develop a linguistically valid and culturally appropriate Filipino version of STAT, and to evaluate its content validity, internal consistency, understandability and ease of performing. Methods: A cross-sectional study on Filipino STAT was conducted in three phases- 1. linguistic validation by experts, 2. cross-cultural adaptation through pre-testing of 12 participants diagnosed with musculoskeletal shoulder condition in the Philippine General Hospital and 3. pilot study on 47 participants of the same population. Results: Results: The Filipino STAT has an excellent content validity (scale validity index=0.80-0.97), excellent interrater reliability (Kappa coefficient=0.82-1.00), and good internal consistency (Cronbach’s alpha=0.87). Understandability is excellent for pain and activity (98%), good for range of motion(ROM) and special test(85%), and poor for strength(37%). 11 participants found the tool difficult to understand with the use of some Tagalog words as the primary barrier, followed by non-familiarity with the tool, and difficulty reading the text. Conclusions: Development of Filipino STAT through a rigorous linguistic validation and cultural adaptation has produced a culturally approriate, valid, and reliable tool. Pain and activity, ROM and special test subdomains are suitable for clinical assessment, while strength subdomain needs further improvement in understandability.

  • Source: freepik; Copyright: freepik; URL: https://www.freepik.com/free-photo/close-up-nurse-helping-diabetic-person-checking-their-glucose-levels_65376759.htm; License: Licensed by JMIR.
    Accessibility

    Jan 15, 2026

    Assessing the Role of Medical Caption Technology to Support Physician-Patient Communication for Patients With Hearing Loss: Mixed Methods Pilot Study

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    Abstract:

    Background: Speech recognition technology is widely used by D/deaf and hard-of-hearing (DHH) individuals in everyday communication, but its clinical applications remain underexplored. Communication barriers in healthcare can compromise safety, understanding, and autonomy for DHH individuals. Objective: This study evaluated a real-time speech recognition system (SRS) tailored for clinical settings, examining its usability, perceived effectiveness, and transcription accuracy among DHH users. Methods: We conducted a pilot study with 10 DHH adults participating in mock outpatient encounters using a custom SRS powered by Google’s speech-to-text API. We employed a convergent parallel mixed-methods design, collecting quantitative usability ratings and qualitative interview data during the same study session. These datasets were subsequently merged and jointly interpreted. Participants completed post-scenario surveys and structured exit interviews assessing distraction, trust, ease of use, satisfaction, and emotional response. Caption accuracy was benchmarked against professional Communication Access Realtime Translation (CART) transcripts using word error rate (WER). Because WER assigns equal weight to all tokens, it does not differentiate between routine transcription errors and those involving safety-critical clinical terms (e.g., medications or diagnoses). Therefore, WER may underestimate the potential impact of certain errors in medical contexts. Results: Across 29 clinical scenario simulations, 86% of participants found captions non-distracting, 90% reported them easy to follow and trustworthy, and 76% were satisfied with the experience. Participants described the SRS as intuitive, emotionally grounding, and preferable to lipreading in masked settings. WER ranged from 12.7% to 22.8%, consistent with benchmarks for automated speech recognition systems. Interviews revealed themes of increased confidence in following clinical conversations and staying engaged despite masked communication. Participants reported less anxiety about missing critical medical information and expressed strong interest in expanding the tool to real-world settings, especially for older adults or those with cognitive impairments. Conclusions: Our findings support the potential of real-time captioning to enhance accessibility and reduce the cognitive and mental burden of communication for DHH individuals in clinical care. Participants described the SRS as both functionally effective and personally empowering. While accuracy for complex medical terminology remains a limitation, participants consistently expressed trust in the system and a desire for its integration into clinical care. Future research should explore real-world implementation, domain-specific optimization, and the development of user-centered evaluation metrics that extend beyond transcription fidelity to include trust, autonomy, and communication equity.

  • Source: Freepik; Copyright: pressfoto; URL: https://www.freepik.com/free-photo/senior-man-texting-cafe_6806267.htm; License: Licensed by JMIR.
    Internet for Rehabilitation

    Jan 7, 2026

    Using a Co-Designed Digital Self-Management Program to Prepare Patients for Hip or Knee Replacement Surgery: Pragmatic Pilot Study

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    Abstract:

    Background: The ageing population has resulted in more people living for longer with musculoskeletal conditions who are in need of hip and knee replacement surgery. Lengthening waiting lists are increasingly a challenge for patients and healthcare services. Objective: This pragmatic study aimed to develop and test a digital self-management intervention (the Hope Programme) to better prepare patients waiting for hip and knee replacement surgery. Methods: The study employed a pragmatic, pre-post with follow-up single-arm design. All intervention and data collection components were delivered online. Following iterative co-development of the intervention, the content was refined and optimised into a final version for testing. The resulting programme was an eight-week intervention delivered via the Hope 4 The Community Interest Company (H4C) digital platform. Data were collected at baseline (pre Hope Programme), 8 weeks (post Hope Programme) and 6 months follow-up. Patient-reported outcome measures related to preparation for surgery, quality of life, physical function, pain, mental wellbeing, self-efficacy and physical activity. Resource utilisation data were collected to calculate the health and social care costs. System Usability Scale data and qualitative satisfaction data were collected post Hope Programme. Results: Thirty-nine participants completed ≥5 of the 8 sessions and all surveys. Among the 25 participants who had surgery at 6 months, 92% felt better prepared due to the Hope Programme. Median improvements in most outcomes were observed at 8 weeks, with several continuing to improve at 6 months. The Friedman test showed significant improvements over 6 months in self-efficacy (pain: P=.002, other symptoms: P<.001), pain (P=.037), health status (P=.022), and mental wellbeing (P=.010). No significant changes were noted in physical activity. While the early cost analysis did not reach statistical significance, it indicated potential cost savings from reduced patient interactions with healthcare professionals. Sixty four percent (25/39) of participants had surgery and this likely contributed in part to improvements in outcomes. System usability was rated above average (mean score 70.1), and post-programme feedback was positive, highlighting peer support, coping strategies, and better preparation for surgery. Conclusions: The results are promising in relation to participants attending the Hope Programme feeling better prepared for surgery. A fully powered efficacy and cost effectiveness trial is needed to determine the contribution of the Hope Programme to outcomes, over and above the contribution of surgery.

  • Source: Freepik; Copyright: DC Studio; URL: https://www.freepik.com/free-photo/specialist-researcher-doctor-discussing-with-sportman-gym-training-equipment-monitoring-body-endurance-medical-workout-modern-laboratory-researcher-doctor-analyzing-ekg-data_20632793.htm; License: Licensed by JMIR.
    Technology in Physiotherapy

    Dec 31, 2025

    Telephone Administration of the Human Activity Profile Questionnaire in Patients With Cardiovascular Disease: Methodological Study

    Authors List:

    Abstract:

    Background: To validate the application of the Human Activity Profile (HAP) questionnaire via telephone call in patients with cardiovascular disease (CVD). Objective: Objective of this study is to investigate the validity of applying the HAP questionnaire via telephone call to patients with cardiovascular disease participating in a cardiovascular rehabilitation program. Methods: Two scores were calculated based upon HAP scores: the maximum activity score (MAS), the number of the most difficult task the respondent is “still doing”; and the adjusted activity score (AAS), the number of items that the individual “stopped doing”, prior to the last one that he “still does”. Patients with CVD answered the HAP questionnaire on 2 random occasions, face-to-face and by telephone call. Results: Fifty-six patients with CVD (64.30% men) with a mean age of 75.14±10.28 years participated in this study. The MAS was similar in both applied modes (Face-to-face: 79.11±11.48; Telephone call: 82.71±7.48; p=0.101). Similarly, The AAS did not differ in both applied modes (Face-to-face: 69.11±14.18; Phone call: 71.21±13.43; p=052). There was high agreement between the two modes of administration (ICC - 0.999; 95%CI, 0.879-0.948; p<0.05). The mean bias and 95% limits of agreement evaluated by Bland-Altman plot for average applied face-to-face and the telephone call versus the mean difference in the MAS and AAS applied face-to-face and the telephone call were, respectively, -4.0 (95%CI 12.1 to -19.3) and -2.1 (95%CI 13.4 to -17.6). Conclusions: The MAS and AAS from HAP can be applied over the telephone call in patients with CVD. Clinical Trial: CAAE 58283422.0.0000.5134 (number: 5.646.387)

  • Source: freepik; Copyright: wavebreakmedia_micro; URL: https://www.freepik.com/free-photo/team-doctors-meeting_9597274.htm; License: Licensed by JMIR.
    Emerging Technologies for Rehabilitation

    Dec 18, 2025

    AI-Based Gait Analysis System for Rehabilitation: Usability Evaluation of Human-Technology Interaction

    Authors List:

    Abstract:

    Background: Artificial intelligence (AI)–based gait analysis systems are increasingly applied in rehabilitation settings for objective and quantitative assessment of gait function. However, despite their potential, clinical adoption remains limited due to insufficient consideration of usability, user experience, and integration into actual clinical workflows. Objective: This study aimed to conduct a formative evaluation of a prototype AI-based gait analysis system (MediStep M). Methods: A mixed methods formative usability evaluation was conducted with 5 licensed physical therapists. Qualitative data were collected through focus group interviews, and quantitative usability was measured using the system usability scale (SUS). A scenario-based usability assessment was applied to identify user interface challenges, workflow issues, and potential design improvements. Results: Participants identified major usability barriers, including limited accessibility of the power button, absence of battery status indicators, burdensome manual calibration, and insufficient clinical detail in the gait analysis reports. They also emphasized the need for wireless operation, improved portability, and integration with hospital electronic medical record systems. The mean SUS score was 57 (grade D), indicating suboptimal usability and the need for iterative design refinements. Conclusions: Although AI-based gait analysis systems hold promise for enhancing rehabilitation outcomes, key usability challenges must be resolved before clinical implementation. Improvements in hardware portability, automated calibration, data management, and user interface design are essential to ensure safety, efficiency, and clinical applicability. These findings provide evidence-based insights to guide iterative development and promote user-centered innovation in AI-based rehabilitation technologies.

  • 3D printed trans tibial prosthetic socket for APOS Ltd by TUS, Athlone. Source: Image created by the authors; Copyright: The authors; URL: https://rehab.jmir.org/2025/1/e73065; License: Creative Commons Attribution (CC-BY).
    Reviews on Innovation in...

    Dec 17, 2025

    Essential Requirements and Relevant Technologies for Load-Bearing 3D-Printed Transtibial Prosthetic Sockets and Their Components: State-of-the-Art Review

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    Abstract:

    Background: The manufacture of load-bearing prosthetic lower limb sockets is traditionally reliant on skilled technicians working with qualified clinicians, creating bespoke solutions. While this approach is effective and, in some situations necessary, the appeal of a sustainable, efficient, and digitalized production solution has made a statement in recent decades that cannot be ignored. The focus of additive manufacturing (AM) is typically on low weight bearing prostheses, which can be misleading for clinics attempting to adopt AM solutions for clientele with weight bearing and/or activity level needs. Objective: This review aims to offer readers a way to approach AM for load bearing requirements as opposed to non-load-bearing counterparts. The use cases of AM for the production of load-bearing trans-tibial prosthetic sockets and components are reviewed to highlight current trends, protocols and standings. Methods: By reviewing publications across the past 25 years, this state-of-the-art review highlights the key requirements and technologies relevant for load bearing trans-tibial prosthetic sockets specifically. Results: The most commonly used AM solutions for commercial use, such as selective laser sintering (SLS) and binder jetting through MultiJet Fusion (MJF), are outlined. As these solutions are most often paired with the structural testing standard ISO 10328, its relevance for evaluating the strength and durability of lower limb sockets is also discussed. Clinician and technician experiences of digitalized ways of working within the prosthetic industry for load bearing applications are outlined. Conclusions: Observations of adoption barriers of AM solutions are brought to light, focusing on clinician and technician education, skillset, exposure to innovative technologies, and trust in the regulation of digital processes in a clinical and technical environment.

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  • Digital Health Interventions and Quality of Life Among Family Caregivers of Stroke Survivors: A Scoping Review

    Date Submitted: Jan 22, 2026

    Open Peer Review Period: Feb 12, 2026 - Apr 9, 2026

    Background: Stroke is a leading cause of long-term disability and often transfers substantial care responsibilities to family and informal caregivers. These demands contribute to multidimensional care...

    Background: Stroke is a leading cause of long-term disability and often transfers substantial care responsibilities to family and informal caregivers. These demands contribute to multidimensional caregiver burden and reduced quality of life (QoL), including psychological distress, social limitations, and financial strain. Digital health interventions—such as mobile applications, messaging-based education, telehealth, and web-based platforms—have the potential to extend caregiver support beyond conventional face-to-face services; however, evidence regarding their impact on caregiver QoL remains heterogeneous. Objective: This scoping review aimed to map and characterize digital health interventions used in stroke caregiving and to summarize their associations with caregiver QoL–related outcomes, including caregiver burden, psychological well-being, empowerment or capability, usability, and access. Methods: A scoping review was conducted in accordance with Joanna Briggs Institute (JBI) guidance and reported following PRISMA-ScR. Searches were performed in PubMed, Scopus, Web of Science, CINAHL, and Google Scholar for English-language studies published between 2019 and 2025. Two reviewers independently screened studies and extracted data using a standardized charting form. Evidence was mapped descriptively by intervention type, delivery characteristics, study design maturity, and caregiver outcome domains. Results: From 676 identified records, 20 studies met the inclusion criteria. Digital interventions were primarily delivered through mobile applications, WhatsApp-based education, telehealth services, or web-based learning platforms. Direct caregiver-focused studies commonly assessed caregiver burden, psychological distress, and caregiving capability, while system-integrated mHealth programs mainly reported patient outcomes with indirect relevance to caregivers. Overall, digital education and follow-up support were associated with reduced caregiver burden and improved caregiver capability and emotional well-being, although outcome measures and follow-up durations varied. Usability, digital literacy, affordability, and connectivity were recurrent barriers. Conclusions: Digital health interventions show promise in improving caregiver QoL in stroke care, particularly through structured education and ongoing support. Future studies should emphasize rigorous caregiver-centered trials, standardized QoL measures, longer follow-up, and inclusive designs addressing digital equity.

  • Generative Artificial Intelligence in Cerebral Palsy Rehabilitation: A Systematic Scoping Review, Ethical Challenges, and Future Perspectives

    Date Submitted: Dec 23, 2025

    Open Peer Review Period: Jan 20, 2026 - Mar 17, 2026

    Background: Cerebral Palsy (CP) is the most frequent motor disability in childhood, with a higher prevalence in low- and middle-income countries where access to essential early rehabilitation is limit...

    Background: Cerebral Palsy (CP) is the most frequent motor disability in childhood, with a higher prevalence in low- and middle-income countries where access to essential early rehabilitation is limited. Generative Artificial Intelligence (GenAI) emerges as a disruptive technology with potential to address these challenges. This scoping reviews maps the current landscape of GenAI applications in CP rehabilitation. Objective: To systematically review and synthesize literature on the use of GenAI in CP rehabilitation, analyzing its applications, reported benefits, technical/ethical challenges, and future research directions. Methods: A systematic search was conducted following PRISMA 2020 guidelines across five databases (PubMed/MEDLINE, Scopus, Web of Science, IEEE Xplore, Google Scholar) through October 2025. Studies utilizing generative models (LLMs, GANs, VAEs, diffusion models) for diagnosis, assessment, therapy planning, documentation, or education in CP were included. Screening and data extraction were performed independently by two reviewers. Results: From 487 initial records, 32 studies (2022-2025) were included, indicating a nascent field dominated by research in high-income countries. Large Language Models (LLMs) constituted 75% of applications. Four key application categories were identified: 1. Diagnosis/Assessment: LLMs enabled early CP detection from clinical notes (Sensitivity:82%); GANs synthesized movement data to improve GMFCS classification accuracy from 72% to 90%. 2. Therapy Planning: LLMs generated personalized exercise regimens (quality 7.8/10 vs. expert 8.9/10); AI-designed VR content increased therapy adherence by >40%. 3. Clinical Documentation: Automation reduced note-writing time by 55%; AI decision support showed 80% concordance with clinical guidelines. 4. Patient/Caregiver Education: Tailored educational materials significantly improved family knowledge scores. Reported benefits included enhanced personalization, efficiency, and accessibility. Critical challenges included hallucinations/factual errors, data privacy concerns, algorithmic bias, a lack of interpretability, and risks of dehumanization. Conclusions: GenAI presents significant potential to augment CP rehabilitation by scaling personalization and improving efficiency. However, current evidence is primarily proof-of-concept. Responsible implementation necessitates: (1) robust clinical trials focusing on functional outcomes, (2) development of domain-specific models, (3) ethical frameworks addressing bias and accountability, (4) strategies for equitable global access, and (5) professional training for AI-augmented practice. GenAI should amplify, not replace, the therapist's expertise and the human therapeutic connection. Our collective choices will determine its ultimate impact on care.

  • Functional Electrical Stimulation for Post-Stroke Motor Recovery: A Systematic Review and Meta-Analysis of Recent Evidence

    Date Submitted: Dec 25, 2025

    Open Peer Review Period: Jan 13, 2026 - Mar 10, 2026

    Background: : Stroke remains a leading cause of motor disability globally. Functional electrical stimulation (FES) has emerged as a promising neurorehabilitation modality, but its comparative efficacy...

    Background: : Stroke remains a leading cause of motor disability globally. Functional electrical stimulation (FES) has emerged as a promising neurorehabilitation modality, but its comparative efficacy, optimal application parameters, and long-term sustainability remain incompletely characterized. Objective: To synthesize evidence from randomized controlled trials and systematic reviews published between 2021 and 2025 regarding the effectiveness of FES interventions for upper and lower limb motor recovery in post-stroke populations. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library databases. Studies were selected based on PRISMA 2020 criteria. Quality appraisal was performed using the Physiotherapy Evidence Database (PEDro) scale and Cochrane Risk of Bias 2 tool. Quantitative synthesis was conducted using random-effects meta-analyses. Results: Twenty-seven studies (n=2,309 stroke participants) were included, encompassing diverse FES modalities: manually controlled, electromyography-triggered, brain-computer interface-controlled, and hybrid systems. Meta-analytic findings demonstrated that FES combined with occupational therapy produced significantly greater improvements in upper limb motor function (Fugl-Meyer Assessment: mean difference [MD] = 5.08, 95% confidence interval [CI] 2.46-7.71) compared to standard care alone. Brain-computer interface-controlled FES achieved superior outcomes (standardized mean difference [SMD] = 0.73, 95% CI 0.26-1.20) particularly when paired with action observation tasks. For lower limb recovery, FES reduced foot drop severity and enhanced gait parameters, with 52% of participants achieving independent walking. Cost-effectiveness analysis demonstrated long-term value (£15,406 per quality-adjusted life year). Adverse events were minimal, primarily limited to temporary skin irritation. Conclusions: FES represents a viable, evidence-supported adjunctive intervention for post-stroke motor recovery across subacute and chronic phases. Emerging technologies integrating brain-computer interfaces and artificial intelligence offer enhanced personalization and efficacy. Future research should prioritize real-world implementation trials, long-term follow-up protocols, and mechanisms underlying neuroplastic adaptations.

  • Impact of a Nonverbal Artificial Intelligence Communication Robot on Quality of Life, Well‑Being, and Acceptability Among Care Facility Staff in a Disaster‑Affected Region: An ABAB Intervention Study

    Date Submitted: Dec 8, 2025

    Open Peer Review Period: Jan 13, 2026 - Mar 10, 2026

    Background: Medical and welfare facilities in the Noto region of Japan were severely affected by the 2024 Noto Peninsula earthquake and the subsequent torrential rains. Staff members working in these...

    Background: Medical and welfare facilities in the Noto region of Japan were severely affected by the 2024 Noto Peninsula earthquake and the subsequent torrential rains. Staff members working in these facilities have been disaster victims and frontline caregivers and face prolonged restoration work with limited psychological support. Nonverbal social robots have been designed to provide companionship and emotional comfort. However, their effects on health-related quality of life (QoL) and well-being among care staff in disaster-affected settings are unknown. Objective: This study aimed to investigate whether introducing a nonverbal artificial intelligence (AI) communication robot can improve QoL and subjective well‑being in care facility staff working under disaster conditions. The secondary objective was to assess the safety, acceptability, and intention to continue using the robot. Methods: An ABAB intervention design was implemented between February and June 2025. After a 2‑week baseline, staff in dementia care, general care, and short‑stay units received the robot intervention for 2 weeks (A1), followed by a 2‑week withdrawal (B1), re‑intervention (A2), and final withdrawal (B2). The questionnaires were administered at the end of each phase. Primary outcomes were health‑related QoL (EQ‑5D‑5L), well‑being (WHO‑5 Well‑Being Index), and mental health continuum (MHC‑SF). Secondary outcomes included safety (three Likert‑scale items), acceptability (17 semantic‑differential items), and interaction frequency. Friedman tests were used to compare outcomes across phases, with Wilcoxon signed-rank tests and Bonferroni correction for post-hoc comparisons. Only participants with complete data across all phases were analyzed. Results: Of the 58 staff completing baseline assessments, 49 provided complete data (25 dementia care, 12 general care, 12 short‑stay). The participants were predominantly female, with a median age in the fifth decade; 75.7% reported personal disaster damage. The median baseline EQ‑5D‑5L utility, WHO‑5 percentage, and MHC‑SF scores were approximately 0.93, 60%, and 35 points, respectively. Interaction frequency with the robot significantly increased during the intervention phases, but Friedman tests showed no significant differences in EQ‑5D‑5L, WHO‑5, or MHC‑SF scores across the ABAB phases within or across units. Safety outcomes and the intention to continue use did not differ between the intervention and withdrawal phases, and no adverse events were reported. Acceptability improved for items, such as “felt calm,” “liked,” and “felt peaceful” in the dementia care unit and for “competent” and “peaceful” in the pooled analysis. However, these effects were insignificant after Bonferroni correction. Conclusions: In this study, the short-term use of a nonverbal AI communication robot did not lead to measurable improvements in QoL or well-being. Nonetheless, the increased interaction and positive acceptability ratings suggest that the robot was well-received and could be safely and feasibly deployed in disaster settings. Long-term studies with larger samples are required to determine whether such robots can provide meaningful mental health support to healthcare workers. Clinical Trial: Not applicable.

  • Telehealth in Occupational Therapy during the COVID-19 Pandemic: A Scoping Review

    Date Submitted: Dec 5, 2025

    Open Peer Review Period: Dec 23, 2025 - Feb 17, 2026

    Background: The COVID-19 pandemic disrupted the delivery of occupational therapy (OT) services in-person on a global scale, accelerating the adoption of telehealth. During this time, there was a surge...

    Background: The COVID-19 pandemic disrupted the delivery of occupational therapy (OT) services in-person on a global scale, accelerating the adoption of telehealth. During this time, there was a surge of OT focussed research on the use of telehealth. Synthesising this literature can be helpful to inform routine practice and to prepare for future disruptions to in-person care, including natural disasters, severe weather, and pandemics. Objective: This scoping review maps the literature on telehealth in OT during COVID-19, focusing on setting, study design, participants, clinical fields, modalities, interventions, outcomes, benefits, barriers, and facilitators. Methods: Using Arksey and O’Malley’s framework and Joanna Briggs Institute guidelines, we searched seven databases and Google Scholar for peer-reviewed articles. Eligibility criteria included: English and French papers reporting on telehealth-delivered OT services during COVID-19, across all ages, conditions, settings, and participant groups. Results: From 4,810 records screened, 43 articles were included. Most articles originated from high-income economies and were small in scale (mean=136; median=15). Most were descriptive (e.g., cross-sectional surveys, qualitative studies, and experiential reports). Participant groups were diverse, including OTs, clients, caregivers, and others (e.g., teachers). Telehealth in OT was most reported in pediatric neurodevelopmental and mental health fields, followed by adult mental health. Most articles described synchronous telehealth and the remaining a mixed approach. Only 40% reported on measurable outcomes, with most of these demonstrating statistically significant results. Reported benefits included improved accessibility, personalization, continuity of care, safety in terms of infection prevention, family engagement, and social support. Perceived barriers included technology access and literacy, lack of physical presence, limitations of the home environment, client and caregiver factors, and organizational challenges. Facilitators included home and intervention adaptations, digital skills and training, caregiver involvement, communication strategies, and organizational and system-level support. Conclusions: Telehealth helps to increase access to OT; however, therapists face barriers in using this approach especially for some interventions and populations. More research is needed on how best to implement telehealth across different populations and contexts.  Clinical Trial: n.a.