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Zhu D, Zhao J, Wang M, Cao B, Zhang W, Li Y, Zhang C, Han T. Rehabilitation Applications Based on Behavioral Therapy for People With Knee Osteoarthritis: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e53798. [PMID: 38696250 PMCID: PMC11099817 DOI: 10.2196/53798] [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: 10/19/2023] [Revised: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND The development of digital applications based on behavioral therapies to support patients with knee osteoarthritis (KOA) has attracted increasing attention in the field of rehabilitation. This paper presents a systematic review of research on digital applications based on behavioral therapies for people with KOA. OBJECTIVE This review aims to describe the characteristics of relevant digital applications, with a special focus on the current state of behavioral therapies, digital interaction technologies, and user participation in design. The secondary aim is to summarize intervention outcomes and user evaluations of digital applications. METHODS A systematic literature search was conducted using the keywords "Knee Osteoarthritis," "Behavior Therapy," and "Digitization" in the following databases (from January 2013 to July 2023): Web of Science, Embase, Science Direct, Ovid, and PubMed. The Mixed Methods Assessment Tool (MMAT) was used to assess the quality of evidence. Two researchers independently screened and extracted the data. RESULTS A total of 36 studies met the inclusion criteria and were further analyzed. Behavioral change techniques (BCTs) and cognitive behavioral therapy (CBT) were frequently combined when developing digital applications. The most prevalent areas were goals and planning (n=31) and repetition and substitution (n=27), which were frequently used to develop physical activity (PA) goals and adherence. The most prevalent combination strategy was app/website plus SMS text message/telephone/email (n=12), which has tremendous potential. This area of application design offers notable advantages, primarily manifesting in pain mitigation (n=24), reduction of physical dysfunction (n=21), and augmentation of PA levels (n=12). Additionally, when formulating design strategies, it is imperative to consider the perspectives of stakeholders, especially in response to the identified shortcomings in application design elucidated within the study. CONCLUSIONS The results demonstrate that "goals and planning" and "repetition and substitution" are frequently used to develop PA goals and PA behavior adherence. The most prevalent combination strategy was app/website plus SMS text message/telephone/email, which has tremendous potential. Moreover, incorporating several stakeholders in the design and development stages might enhance user experience, considering the distinct variations in their requirements. To improve the efficacy and availability of digital applications, we have several proposals. First, comprehensive care for patients should be ensured by integrating multiple behavioral therapies that encompass various aspects of the rehabilitation process, such as rehabilitation exercises and status monitoring. Second, therapists could benefit from more precise recommendations by incorporating additional intelligent algorithms to analyze patient data. Third, the implementation scope should be expanded from the home environment to a broader social community rehabilitation setting.
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Affiliation(s)
- Dian Zhu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Jianan Zhao
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Mingxuan Wang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Bochen Cao
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Wenhui Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Yunlong Li
- Department of Design, Jiangxi Science and Technology Normal University, Shanghai, China
| | - Chenqi Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Han
- School of Design, Shanghai Jiao Tong University, Shanghai, China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
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Gardner EC, Podbielski C, Dunphy E. Telerehabilitation to Address the Rehabilitation Gap in Anterior Cruciate Ligament Care: Survey of Physical Therapists/Care Providers. TELEMEDICINE REPORTS 2024; 5:18-35. [PMID: 38469166 PMCID: PMC10927236 DOI: 10.1089/tmr.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 03/13/2024]
Abstract
Background While the importance of structured rehabilitation following anterior cruciate ligament reconstruction (ACLR), particularly in the return-to-sport phase, is known, for most patients, supervised physical therapy is often completed before this time point. The recent emergence of telerehabilitation and other digital health interventions has the potential to address this "rehabilitation gap." Methods The study was conducted as a cross-section, online survey collecting qualitative and quantitative data from open and closed questions. Inclusion criteria included local qualified physical therapists or other professionals working with ACLR patients. Results Eighty-three percent of respondents experienced a "rehabilitation gap" with their ACLR patients. Few reported currently utilizing apps or websites (9.74%). The majority (41/58) reported experience with telerehabilitation, and 84% felt that there was a role for digital rehabilitation strategies to address the "rehabilitation gap." The vast majority (94.74%) of participants felt that standard commercial insurance did not permit sufficient rehabilitation. Discussion While the majority of our respondents acknowledged the existence of a "rehabilitation gap," as well as familiarity with and confidence in telerehabilitation, few were using this technique at the time of our survey. This suggests an opportunity for development in this space.
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Affiliation(s)
- Elizabeth C. Gardner
- Department of Orthopedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Corey Podbielski
- Outpatient Physical Therapy, Gaylord Speciality Healthcare, Wallingford, Connecticut, USA
| | - Emma Dunphy
- Research Department of Primary Care and Populational Health, Upper Third Floor, UCL Medical School (Royal Free Campus), London, United Kingdom
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Braun M, Carlier S, De Backere F, De Paepe A, Van De Velde M, Van Dyck D, Marques MM, De Turck F, Crombez G. Content and quality of physical activity ontologies: a systematic review. Int J Behav Nutr Phys Act 2023; 20:28. [PMID: 36907890 PMCID: PMC10009987 DOI: 10.1186/s12966-023-01428-y] [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: 06/08/2022] [Accepted: 02/24/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION Ontologies are a formal way to represent knowledge in a particular field and have the potential to transform the field of health promotion and digital interventions. However, few researchers in physical activity (PA) are familiar with ontologies, and the field can be difficult to navigate. This systematic review aims to (1) identify ontologies in the field of PA, (2) assess their content and (3) assess their quality. METHODS Databases were searched for ontologies on PA. Ontologies were included if they described PA or sedentary behavior, and were available in English language. We coded whether ontologies covered the user profile, activity, or context domain. For the assessment of quality, we used 12 criteria informed by the Open Biological and Biomedical Ontology (OBO) Foundry principles of good ontology practice. RESULTS Twenty-eight ontologies met the inclusion criteria. All ontologies covered PA, and 19 included information on the user profile. Context was covered by 17 ontologies (physical context, n = 12; temporal context, n = 14; social context: n = 5). Ontologies met an average of 4.3 out of 12 quality criteria. No ontology met all quality criteria. DISCUSSION This review did not identify a single comprehensive ontology of PA that allowed reuse. Nonetheless, several ontologies may serve as a good starting point for the promotion of PA. We provide several recommendations about the identification, evaluation, and adaptation of ontologies for their further development and use.
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Affiliation(s)
- Maya Braun
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Stéphanie Carlier
- IDLab, Department of Information Technology, Ghent University - imec, Ghent, Belgium
| | - Femke De Backere
- IDLab, Department of Information Technology, Ghent University - imec, Ghent, Belgium
| | - Annick De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marie Van De Velde
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marta M Marques
- Nova Medical School, Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, Lisbon, Portugal
| | - Filip De Turck
- IDLab, Department of Information Technology, Ghent University - imec, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Murray E, Goodfellow H, Bindman J, Blandford A, Bradbury K, Chaudhry T, Fernandez-Reyes D, Gomes M, Hamilton FL, Heightman M, Henley W, Hurst JR, Hylton H, Linke S, Pfeffer P, Ricketts W, Robson C, Singh R, Stevenson FA, Walker S, Waywell J. Development, deployment and evaluation of digitally enabled, remote, supported rehabilitation for people with long COVID-19 (Living With COVID-19 Recovery): protocol for a mixed-methods study. BMJ Open 2022; 12:e057408. [PMID: 35131836 PMCID: PMC8822541 DOI: 10.1136/bmjopen-2021-057408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Long COVID-19 is a distressing, disabling and heterogeneous syndrome often causing severe functional impairment. Predominant symptoms include fatigue, cognitive impairment ('brain fog'), breathlessness and anxiety or depression. These symptoms are amenable to rehabilitation delivered by skilled healthcare professionals, but COVID-19 has put severe strain on healthcare systems. This study aims to explore whether digitally enabled, remotely supported rehabilitation for people with long COVID-19 can enable healthcare systems to provide high quality care to large numbers of patients within the available resources. Specific objectives are to (1) develop and refine a digital health intervention (DHI) that supports patient assessment, monitoring and remote rehabilitation; (2) develop implementation models that support sustainable deployment at scale; (3) evaluate the impact of the DHI on recovery trajectories and (4) identify and mitigate health inequalities due to the digital divide. METHODS AND ANALYSIS Mixed-methods, theoretically informed, single-arm prospective study, combining methods drawn from engineering/computer science with those from biomedicine. There are four work packages (WP), one for each objective. WP1 focuses on identifying user requirements and iteratively developing the intervention to meet them; WP2 combines qualitative data from users with learning from implementation science and normalisation process theory, to promote adoption, scale-up, spread and sustainability of the intervention; WP3 uses quantitative demographic, clinical and resource use data collected by the DHI to determine illness trajectories and how these are affected by use of the DHI; while WP4 focuses on identifying and mitigating health inequalities and overarches the other three WPs. ETHICS AND DISSEMINATION Ethical approval obtained from East Midlands - Derby Research Ethics Committee (reference 288199). Our dissemination strategy targets three audiences: (1) Policy makers, Health service managers and clinicians responsible for delivering long COVID-19 services; (2) patients and the public; (3) academics. TRIAL REGISTRATION NUMBER Research Registry number: researchregistry6173.
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Affiliation(s)
- Elizabeth Murray
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Henry Goodfellow
- Department of Primary Care and Population Health, University College London, London, UK
| | - Julia Bindman
- Research Department of Primary Care and Population Health, University College London, London, UK
| | | | | | - Tahreem Chaudhry
- Department of Primary Care and Population Health, University College London, London, UK
| | | | - Manuel Gomes
- Department for Applied Health Research, University College London, London, UK
| | - Fiona L Hamilton
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Melissa Heightman
- Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - William Henley
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - John R Hurst
- Academic Unit of Respiratory Medicine, University College London, London, UK
| | - Hannah Hylton
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | - Stuart Linke
- Camden and Islington NHS Foundation Trust, London, UK
| | - Paul Pfeffer
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | - William Ricketts
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | | | - Richa Singh
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | - Fiona A Stevenson
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sarah Walker
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
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