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Curtis S, Sheehan L, Buchman E, Bhattacharjya S. Clinicians' perspectives and usage of rehabilitation technology: a survey. Disabil Rehabil Assist Technol 2024; 19:2298-2305. [PMID: 37987735 DOI: 10.1080/17483107.2023.2284365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/18/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The aim of this study was to investigate clinicians' perspectives regarding their usage of rehabilitation technology in their day-to-day practice and uncover the factors that impact clinicians' use of rehabilitation technology in their daily practice. MATERIALS AND METHODS An online survey was used to gather cross-sectional data from American occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and speech language pathologists. This survey used Likert-scale, multiple choice, and free-response questions. RESULTS Approximately half (n = 56/105, 53.3%) of our clinicians reported using rehabilitation in their daily practice. Less than 20% (n = 18/105, 17.1%) of the respondents strongly agreed that they felt comfortable implementing new rehabilitation technology, and few reported that their workplace encouraged (n = 16/85, 18.8%) or strongly encouraged (n = 14/85, 16.5%) the use of rehabilitation technology in practice. Additionally, excluding the 2011-2020 graduate clinicians that reported that they had not learned about rehabilitation technology in school or fieldwork, few reported feeling prepared (n = 14/97, 14.4%) or very prepared (n = 4/97, 4.1%) to use rehabilitation technology after graduation. CONCLUSIONS Our findings have revealed a sizable knowledge-to-practice gap in regard to clinicians' preparedness to engage with and advocate for rehabilitation technology in their day-to-day practice.
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Affiliation(s)
- Sarah Curtis
- Department of Occupational Therapy, GA State University, Atlanta, GA, USA
| | | | - Emily Buchman
- Department of Occupational Therapy, GA State University, Atlanta, GA, USA
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Winterbottom L, Chen A, Mendonca R, Nilsen DM, Ciocarlie M, Stein J. Clinician perceptions of a novel wearable robotic hand orthosis for post-stroke hemiparesis. Disabil Rehabil 2024:1-10. [PMID: 38975689 DOI: 10.1080/09638288.2024.2375056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 06/27/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE Wearable robotic devices are currently being developed to improve upper limb function for individuals with hemiparesis after stroke. Incorporating the views of clinicians during the development of new technologies can help ensure that end products meet clinical needs and can be adopted for patient care. METHODS In this cross-sectional mixed-methods study, an anonymous online survey was used to gather clinicians' perceptions of a wearable robotic hand orthosis for post-stroke hemiparesis. Participants were asked about their clinical experience and provided feedback on the prototype device after viewing a video. RESULTS 154 participants completed the survey. Only 18.8% had previous experience with robotic technology. The majority of participants (64.9%) reported that they would use the device for both rehabilitative and assistive purposes. Participants perceived that the device could be used in supervised clinical settings with all phases of stroke. Participants also indicated a need for insurance coverage and quick setup time. CONCLUSIONS Engaging clinicians early in the design process can help guide the development of wearable robotic devices. Both rehabilitative and assistive functions are valued by clinicians and should be considered during device development. Future research is needed to understand a broader set of stakeholders' perspectives on utility and design.
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Affiliation(s)
- Lauren Winterbottom
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, USA
| | - Ava Chen
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Rochelle Mendonca
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, USA
| | - Dawn M Nilsen
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, USA
- NewYork-Presbyterian Hospital, New York, NY, USA
| | - Matei Ciocarlie
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Joel Stein
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, USA
- NewYork-Presbyterian Hospital, New York, NY, USA
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Alt Murphy M, Pradhan S, Levin MF, Hancock NJ. Uptake of Technology for Neurorehabilitation in Clinical Practice: A Scoping Review. Phys Ther 2024; 104:pzad140. [PMID: 37856528 PMCID: PMC10851848 DOI: 10.1093/ptj/pzad140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Technology-based interventions offer many opportunities to enhance neurorehabilitation, with associated research activity gathering pace. Despite this fact, translation for use in clinical practice has lagged research innovation. An overview of the current "state of play" regarding the extent of clinical uptake and factors that might influence use of technologies is required. This scoping review explored the uptake of technologies as neurorehabilitation interventions in clinical practice and factors that are reported to influence their uptake. METHODS This systematic scoping review was conducted with narrative synthesis and evidence mapping. Studies of any design reporting uptake or implementation of technology (wearable devices, virtual reality, robotics, and exergaming) for movement neurorehabilitation after stroke and other neurological conditions were sought via a formal search strategy in MEDLINE (Ovid), CINAHL, AMED, and Embase. Full-text screening and data extraction were completed independently by 2 reviewers. RESULTS Of 609 studies returned, 25 studies were included after title, abstract, and full-text screening. Studies investigated a range of technologies at various stages of development. Only 4 of the included studies explored the sustained use of technology in practice. The following 5 themes representing experiences of technology use emerged: perceived usefulness, technology design, social interaction, integration with services, and suggested improvements to enhance uptake. CONCLUSION Reporting of uptake and use of neurorehabilitation technologies in clinical practice is limited. The synthesis provided comprehensive knowledge of barriers to and facilitators of uptake to be considered in future protocols, including a steep learning curve required to engage with technology, a need for a supportive organizational culture, and a need for user involvement in both design and development. IMPACT This scoping review has provided indicators from current evidence of important factors to consider in the planning of research into and clinical implementation of technologies for neurorehabilitation. It serves to support an evidence-based, user-centered platform for improved research on and translation of technologies in neurorehabilitation clinical practice.
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Affiliation(s)
- Margit Alt Murphy
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sujata Pradhan
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Mindy F Levin
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Nicola J Hancock
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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Brassel S, Brunner M, Campbell A, Power E, Togher L. Exploring Discussions About Virtual Reality on Twitter to Inform Brain Injury Rehabilitation: Content and Network Analysis. J Med Internet Res 2024; 26:e45168. [PMID: 38241072 PMCID: PMC10837760 DOI: 10.2196/45168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/06/2023] [Accepted: 10/29/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Virtual reality (VR) use in brain injury rehabilitation is emerging. Recommendations for VR development in this field encourage end user engagement to determine the benefits and challenges of VR use; however, existing literature on this topic is limited. Data from social networking sites such as Twitter may further inform development and clinical practice related to the use of VR in brain injury rehabilitation. OBJECTIVE This study collected and analyzed VR-related tweets to (1) explore the VR tweeting community to determine topics of conversation and network connections, (2) understand user opinions and experiences of VR, and (3) identify tweets related to VR use in health care and brain injury rehabilitation. METHODS Publicly available tweets containing the hashtags #virtualreality and #VR were collected up to twice weekly during a 6-week period from July 2020 to August 2020 using NCapture (QSR International). The included tweets were analyzed using mixed methods. All tweets were coded using inductive content analysis. Relevant tweets (ie, coded as "VR in health care" or "talking about VR") were further analyzed using Dann's content coding. The biographies of users who sent relevant tweets were examined descriptively. Tweet data networks were visualized using Gephi computational analysis. RESULTS A total of 260,715 tweets were collected, and 70,051 (26.87%) were analyzed following eligibility screening. The sample comprised 33.68% (23,596/70,051) original tweets and 66.32% (46,455/70,051) retweets. Content analysis generated 10 main categories of original tweets related to VR (ie, advertising and promotion, VR content, talking about VR, VR news, general technology, VR industry, VR live streams, VR in health care, VR events, and VR community). Approximately 4.48% (1056/23,596) of original tweets were related to VR use in health care, whereas 0.19% (45/23,596) referred to VR in brain injury rehabilitation. In total, 14.86% (3506/23,596) of original tweets featured commentary on user opinions and experiences of VR applications, equipment, and software. The VR tweeting community comprised a large network of 26,001 unique Twitter users. Users that posted tweets related to "VR in health care" (2124/26,001, 8.17%) did not form an interconnected VR network, whereas many users "talking about VR" (3752/26,001, 14.43%) were connected within a central network. CONCLUSIONS This study provides valuable data on community-based experiences and opinions related to VR. Tweets showcased various VR applications, including in health care, and identified important user-based considerations that can be used to inform VR use in brain injury rehabilitation (eg, technical design, accessibility, and VR sickness). Limited discussions and small user networks related to VR in brain injury rehabilitation reflect the paucity of literature on this topic and the potential underuse of this technology. These findings emphasize that further research is required to understand the specific needs and perspectives of people with brain injuries and clinicians regarding VR use in rehabilitation.
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Affiliation(s)
- Sophie Brassel
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Leanne Togher
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Western Sydney Local Health District, Sydney, Australia
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Cook AB, Donoso Brown E, Hambrose M, Schreiber J. Occupational Therapy Practitioners' Implementation of Home Programs for Individuals Post Burn: An Initial Cross-Sectional Survey. Occup Ther Health Care 2023:1-17. [PMID: 37497627 DOI: 10.1080/07380577.2023.2240395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 07/20/2023] [Indexed: 07/28/2023]
Abstract
Occupational therapy practitioners who care for individuals post burn often prescribe home programs to facilitate continued progress toward occupational therapy goals. This study identified the components included in home programs, how practitioners create and prescribe home programs, and perceived supports and barriers to adherence in this population. Thirty-nine practitioners employed at American Burn Association-verified centers completed an online survey. Results suggest that home programs are primarily designed to address range of motion with less emphasis on function. The highest-ranked barriers to adherence were pain and lack of motivation while the highest-ranked supports were client motivation and family/caregiver support. Practitioners reported using handouts and demonstration frequently for delivery, with infrequent use of technology. Recommendations for incorporating evidence-based strategies into home program creation and administration are included.
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Affiliation(s)
- Ann B Cook
- Occupational Therapy Department, Slippery Rock University, Slippery Rock, USA
| | - E Donoso Brown
- Occupational Therapy Department, Duquesne University, Pittsburgh, USA
| | - M Hambrose
- Sunnyview Rehabilitation Hospital, Schenectady, USA
| | - J Schreiber
- School of Nursing, Duquesne University, Pittsburgh, USA
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Bower KJ, Thilarajah S, Williams G, Pua YH, Tan D, Clark RA. Quiet standing postural control variables in subacute stroke: associations with gait and balance, falls prediction and responsiveness. Disabil Rehabil 2023; 45:1299-1306. [PMID: 35382664 DOI: 10.1080/09638288.2022.2055796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To examine the construct validity, predictive validity and responsiveness of standing centre of pressure variables in subacute stroke. MATERIALS AND METHODS Seventy-nine ambulatory individuals were assessed before inpatient rehabilitation discharge and three months later. Measures were: gait speed (6-metre walk), dynamic balance (step test), and quiet standing (Wii Balance Board). Centre of pressure speed, amplitude, standard deviation, root mean square, wavelet decomposition, and detrended fluctuation analysis were examined. Falls data were collected over a 12-month period post-discharge. RESULTS Moderate strength correlations (r = -0.505 to -0.548) with gait speed and step test scores were shown for 3/26 centre of pressure variables (mediolateral speed, low and moderate frequency wavelet). Twenty-two participants fell and the prediction was significant for gait speed and step test (IQR-odds ratio (OR) = 4.00 & 3.21) and 3/26 centre of pressure variables (mediolateral low-frequency wavelet: IQR-OR = 2.71; mediolateral detrended fluctuation analysis: IQR-OR = 3.06; anteroposterior detrended fluctuation analysis: IQR-OR = 2.71). Significant changes over time occurred for gait speed and step test scores and 20/26 centre of pressure variables. CONCLUSIONS Standing centre of pressure variables have limited validity to reflect dynamic balance and falls risk after stroke. Frequency and complexity measures warrant further exploration.Implications for rehabilitationOur findings indicate that quiet standing centre of pressure variables have limited validity to reflect dynamic balance tasks and predict falls after stroke.The mediolateral and higher frequency variables may be more strongly recommended than the commonly used total centre of pressure speed measure.Measures of signal frequency and complexity may provide insight into postural control mechanisms and how these change over time following stroke.
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Affiliation(s)
- Kelly J Bower
- Department of Physiotherapy, University of Melbourne, Carlton VIC, Australia
| | | | - Gavin Williams
- Department of Physiotherapy, University of Melbourne, Carlton VIC, Australia
- Epworth Healthcare, Richmond, VIC, Australia
| | - Yong-Hao Pua
- Singapore General Hospital, Singapore, Singapore
| | - Dawn Tan
- Singapore General Hospital, Singapore, Singapore
| | - Ross A Clark
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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7
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Brassel S, Brunner M, Power E, Campbell A, Togher L. Speech-Language Pathologists' Views of Using Virtual Reality for Managing Cognitive-Communication Disorders Following Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:907-923. [PMID: 36580534 DOI: 10.1044/2022_ajslp-22-00077] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Using virtual reality (VR) to support rehabilitation is an emerging area of research that may offer people with communication disorders a stable and safe communication environment to practice their communication skills. There are currently no VR applications that have been designed to assess or treat cognitive-communication disorders (CCDs) following traumatic brain injury (TBI). Therefore, this study aimed to explore the views of speech-language pathologists (SLPs) who work with people who have a TBI to generate ideas and considerations for using VR in rehabilitation for CCDs. VR researchers were included to provide expert advice about VR technology. METHOD A total of 14 SLPs and three VR specialists participated in an online interview or focus group. Semistructured discussions explored participants' perspectives related to potential ideas for VR use and any perceived barriers and facilitators to VR implementation for managing CCDs following TBI. Data were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. RESULTS Three main themes were generated from thematic analysis: VR is a tool that could enhance clinical practice, the need to consider and navigate potential red flags, and solutions to pave the way forward. Suggestions to overcome perceived barriers to VR use were also provided. DISCUSSION Participants expressed interest in using VR for rehabilitation of CCDs following TBI. However, potential barriers and risks to use should be considered prior to implementation. The findings offer guidance to support future research and development of VR in this field. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21669647.
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Affiliation(s)
- Sophie Brassel
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Melissa Brunner
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Andrew Campbell
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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8
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Sharma Y, Cheung L, Patterson KK, Iaboni A. Factors Influencing the Clinical Adoption of Quantitative Gait Analysis Technologies for Adult Patient Populations With a Focus on Clinical Efficacy and Clinician Perspectives: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e39767. [PMID: 36947120 PMCID: PMC10131694 DOI: 10.2196/39767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/14/2022] [Accepted: 01/24/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Quantitative gait analysis can support clinical decision-making. These analyses can be performed using wearable sensors, nonwearable sensors, or a combination of both. However, to date, they have not been widely adopted in clinical practice. Technology adoption literature has highlighted the clinical efficacy of technology and the users' perspective on the technology (eg, ease of use and usefulness) as some factors that influence their widespread adoption. OBJECTIVE To assist with the clinical adoption of quantitative gait technologies, this scoping review will synthesize the literature on their clinical efficacy and clinician perspectives on their use in the clinical care of adult patient populations. METHODS This scoping review protocol follows the Joanna Briggs Institute methodology for scoping reviews. The review will include both peer-reviewed and gray literature (ie, conference abstracts) regarding the clinical efficacy of quantitative gait technologies and clinician perspectives on their use in the clinical care of adult patient populations. A comprehensive search strategy was created in MEDLINE (Ovid), which was then translated to 4 other databases: CENTRAL (Ovid), Embase (Ovid), CINAHL (EBSCO), and SPORTDiscus (EBSCO). The title and abstract screening, full-text review, and data extraction of relevant articles will be performed independently by 2 reviewers, with a third reviewer involved to support the resolution of conflicts. Data will be analyzed using content analysis and summarized in tabular and diagram formats. RESULTS A search of relevant articles will be conducted in all 5 databases, and through hand-searching in Google Scholar and PEDro, including articles published up until December 2022. The research team plans to submit the final scoping review for publication in a peer-reviewed journal in 2023. CONCLUSIONS The findings of this review will be presented at clinical science conferences and published in a peer-reviewed journal. This review will inform future studies designed to develop, evaluate, or implement quantitative gait analysis technologies in clinical practice. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39767.
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Affiliation(s)
- Yashoda Sharma
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Kara K Patterson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Andrea Iaboni
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Torres-Castaño A, Abt-Sacks A, Toledo-Chávarri A, Suarez-Herrera JC, Delgado-Rodríguez J, León-Salas B, González-Hernández Y, Carmona-Rodríguez M, Serrano-Aguilar P. Ethical, Legal, Organisational and Social Issues of Teleneurology: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3694. [PMID: 36834388 PMCID: PMC9962592 DOI: 10.3390/ijerph20043694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. Teleneurology (TN) allows neurology to be applied when the doctor and patient are not present in the same place, and sometimes not at the same time. In February 2021, the Spanish Ministry of Health requested a health technology assessment report on the implementation of TN as a complement to face-to-face neurological care. METHODS A scoping review was conducted to answer the question on the ethical, legal, social, organisational, patient (ELSI) and environmental impact of TN. The assessment of these aspects was carried out by adapting the EUnetHTA Core Model 3.0 framework, the criteria established by the Spanish Network of Health Technology Assessment Agencies and the analysis criteria of the European Validate (VALues In Doing Assessments of healthcare TEchnologies) project. Key stakeholders were invited to discuss their concerns about TN in an online meeting. Subsequently, the following electronic databases were consulted from 2016 to 10 June 2021: MEDLINE and EMBASE. RESULTS 79 studies met the inclusion criteria. This scoping review includes 37 studies related to acceptability and equity, 15 studies developed during COVID and 1 study on environmental aspects. Overall, the reported results reaffirm the necessary complementarity of TN with the usual face-to-face care. CONCLUSIONS This need for complementarity relates to factors such as acceptability, feasibility, risk of dehumanisation and aspects related to privacy and the confidentiality of sensitive data.
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Affiliation(s)
- Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - José Carlos Suarez-Herrera
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- UNITWIN/UNESCO Chair, Research, Planning and Development of Local Health Systems, Department of Clinical Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Janet Delgado-Rodríguez
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
- Department of Philosophy I, University of Granada, 18071 Granada, Spain
| | - Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Yadira González-Hernández
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
| | - Montserrat Carmona-Rodríguez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), 28071 Madrid, Spain
- Health Technology Assessment Agency, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro Serrano-Aguilar
- Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain
- Institute of Biomedical Technologies, University of La Laguna, 38200 Tenerife, Spain
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10
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Ryan JL, Beal DS, Levac DE, Fehlings DL, Wright FV. Integrating Transcranial Direct Current Stimulation into an Existing Inpatient Physiotherapy Program to Enhance Motor Learning in an Adolescent with Traumatic Brain Injury: A Case Report. Phys Occup Ther Pediatr 2023:1-19. [PMID: 36624962 DOI: 10.1080/01942638.2022.2163214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Describe how transcranial direct current stimulation (tDCS) was incorporated into an inpatient physiotherapy program for an adolescent with severe traumatic brain injury (TBI), detail the motor learning focus of the physiotherapy sessions, and summarize gross motor progress. METHOD This case report describes an adolescent who received 20 minutes of anodal tDCS immediately prior to 16 physiotherapy sessions over four weeks. Potential side effects were tracked pre/post tDCS. Gross motor outcomes were measured pre-intervention, post-intervention, and three months post-intervention. Physiotherapy session content was analyzed using therapist documentation and the Motor Learning Strategies Rating Instrument. RESULTS The youth tolerated tDCS well. The primary side effect was itchiness under the electrodes during tDCS sessions. His mobility progressed from wheelchair use pre- 'tDCS + physiotherapy' to ambulation with a walker post-intervention. His Gross Motor Function Measure score increased 33.1% points pre/post intervention. Session tasks often had several foci (e.g., skill acquisition, strength, and balance) with task focus changing as the youth progressed. Various motor learning strategies were layered within tasks to support performance and learning. CONCLUSIONS tDCS was successfully integrated into an existing inpatient physiotherapy program for an adolescent with TBI. This protocol provides a structure for implementing, monitoring, and measuring tDCS + physiotherapy in pediatric rehabilitation.
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Affiliation(s)
- Jennifer L Ryan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deryk S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Danielle E Levac
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Darcy L Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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11
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Gamified Neurorehabilitation Strategies for Post-stroke Motor Recovery: Challenges and Advantages. Curr Neurol Neurosci Rep 2022; 22:183-195. [PMID: 35278172 PMCID: PMC8917333 DOI: 10.1007/s11910-022-01181-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
Abstract Purpose of Review Stroke is the leading cause of permanent motor disability in the United States (US), but there has been little progress in developing novel, effective strategies for treating post-stroke motor deficits. The past decade has seen the rapid development of many promising, gamified neurorehabilitation technologies; however, clinical adoption remains limited. The purpose of this review is to evaluate the recent literature surrounding the adoption and use of gamification in neurorehabilitation after stroke. Recent Findings Gamification of neurorehabilitation protocols is both feasible and effective. Deployment strategies and scalability need to be addressed with more rigor. Relationship between engaged time on task and rehabilitation outcomes should be explored further as it may create benefits beyond repetitive movement. Summary As gamification becomes a more common and feasible way of delivering exercise-based therapies, additional benefits of gamification are emerging. In spite of this, questions still exist about scalability and widespread clinical adoption.
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Selamat SNS, Che Me R, Ahmad Ainuddin H, Salim MSF, Ramli HR, Romli MH. The Application of Technological Intervention for Stroke Rehabilitation in Southeast Asia: A Scoping Review With Stakeholders' Consultation. Front Public Health 2022; 9:783565. [PMID: 35198531 PMCID: PMC8858807 DOI: 10.3389/fpubh.2021.783565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/31/2021] [Indexed: 01/03/2023] Open
Abstract
Background The technological intervention is considered as an adjunct to the conventional therapies applied in the rehabilitation session. In most high-income countries, technology has been widely used in assisting stroke survivors to undergo their treatments. However, technology use is still lacking in Southeast Asia, especially in middle- and low-income countries. This scoping review identifies and summarizes the technologies and related gaps available in Southeast Asia pertaining to stroke rehabilitation. Methods The JBI manual for evidence synthesis was used to conduct a scoping study. Until September 2021, an electronic search was performed using four databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only the studies that were carried out in Southeast Asia were chosen. Results Forty-one articles were chosen in the final review from 6,873 articles found during the initial search. Most of the studies reported the implementation of technological intervention combined with conventional therapies in stroke rehabilitation. Advanced and simple technologies were found such as robotics, virtual reality, telerehabilitation, motion capture, assistive devices, and mobility training from Singapore, Thailand, Malaysia, and Indonesia. The majority of the studies show that technological interventions can enhance the recovery period of stroke survivors. The consultation session suggested that the technological interventions should facilitate the needs of the survivors, caregivers, and practitioners during the rehabilitation. Conclusions The integration of technology into conventional therapies has shown a positive outcome and show significant improvement during stroke recovery. Future studies are recommended to investigate the potential of home-based technological intervention and lower extremities.
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Affiliation(s)
- Siti Nur Suhaidah Selamat
- Department of Industrial Design, Faculty of Design and Architecture, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Rosalam Che Me
- Department of Industrial Design, Faculty of Design and Architecture, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- *Correspondence: Rosalam Che Me
| | - Husna Ahmad Ainuddin
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Centre of Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Shah Alam, Malaysia
| | - Mazatulfazura S. F. Salim
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Rehabilitation Medicine, Hospital Pengajar, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Hafiz Rashidi Ramli
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Muhammad Hibatullah Romli
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Rehabilitation Medicine, Hospital Pengajar, Universiti Putra Malaysia, Seri Kembangan, Malaysia
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Buckingham SA, Anil K, Demain S, Gunn H, Jones RB, Kent B, Logan A, Marsden J, Playford ED, Freeman J. Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners. JMIRX MED 2022; 3:e30516. [PMID: 37725532 PMCID: PMC10414449 DOI: 10.2196/30516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 09/21/2023]
Abstract
BACKGROUND Telerehabilitation is a feasible and potentially effective alternative to face-to-face rehabilitation. However, specific guidance, training, and support for practitioners who undertake remote assessments in people with physical disabilities and movement impairment are limited. OBJECTIVE The aims of this survey of United Kingdom-based health and social care practitioners were to explore experiences, assess training needs, and collate ideas on best practices in telerehabilitation for physical disabilities and movement impairment. The aim will be to use the findings to inform a practical tool kit and training package for telerehabilitation use. METHODS UK rehabilitation practitioners were invited to complete an online questionnaire from November to December 2020. Opportunity and snowball sampling were used to recruit participants from professional and educational networks, special interest groups, and via social media. Closed questionnaire items were analyzed using descriptive statistics. Qualitative inductive analysis using NVivo was used for open responses. RESULTS There were 247 respondents, of which 177 (72%) were physiotherapists and occupational therapists. Most (n=207, 84%) had used video-based consultations (typically supported by telephone and email), and the use of this method had increased in frequency since the COVID-19 pandemic. Practitioners perceived telerehabilitation positively overall and recognized benefits for patients including a reduced infection risk, convenience and flexibility, and reduced travel and fatigue. Common obstacles were technology related (eg, internet connection), practical (eg, difficulty positioning the camera), patient related (eg, health status), practitioner related (eg, lack of technical skills), and organizational (eg, lack of access to technology). Support from family members or carers was a major facilitator for successful remote consultations. Of the 207 respondents who had used video-based consultations, 103 (50%) had assessed physical impairments using this method, 107 (52%) had assessed physical function, and 121 (59%) had used patient-reported outcome measures. Although practitioners generally felt confident in delivering video-based consultations, they felt less proficient in undertaking remote physical assessments, expressing concerns about validity, reliability, and safety. Only 46 of the 247 (19%) respondents had received any training in telerehabilitation or video consultations, and some felt they were "feeling their way in the dark." Practitioners desired training and guidance on physical assessment tools suitable for remote use, when to use video-based consultations or alternative methods, governance issues, digital platforms, and signposting to digital skills training for themselves and their patients. CONCLUSIONS In response to the COVID-19 pandemic, practitioners rapidly adopted telerehabilitation for people with physical disabilities and movement impairment. However, there are technical, practical, and organizational obstacles to overcome, and a clear need for improved guidance and training in remote physical assessments. The findings of this survey will inform the development of a tool kit of resources and a training package for the current and future workforce in telerehabilitation.
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Affiliation(s)
- Sarah A Buckingham
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Krithika Anil
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Sara Demain
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Hilary Gunn
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Ray B Jones
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom
| | - Angela Logan
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Jonathan Marsden
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - E Diane Playford
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
- Central England Rehabilitation Unit, Royal Leamington Spa Rehabilitation Hospital, Warwick, United Kingdom
| | - Jennifer Freeman
- School of Health Professions, University of Plymouth, Plymouth, United Kingdom
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