JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Detection of Low Back Physiotherapy Exercises With Inertial Sensors and Machine Learning: Algorithm Development and Validation.","authors":"Abdalrahman Alfakir,&nbsp;Colin Arrowsmith,&nbsp;David Burns,&nbsp;Helen Razmjou,&nbsp;Michael Hardisty,&nbsp;Cari Whyne","doi":"10.2196/38689","DOIUrl":"https://doi.org/10.2196/38689","url":null,"abstract":"<p><strong>Background: </strong>Physiotherapy is a critical element in the successful conservative management of low back pain (LBP). A gold standard for quantitatively measuring physiotherapy participation is crucial to understanding physiotherapy adherence in managing recovery from LBP.</p><p><strong>Objective: </strong>This study aimed to develop and evaluate a system with wearable inertial sensors to objectively detect the performance of unsupervised exercises for LBP comprising movement in multiple planes and sitting postures.</p><p><strong>Methods: </strong>A quantitative classification design was used within a machine learning framework to detect exercise performance and posture in a cohort of healthy participants. A set of 8 inertial sensors were placed on the participants, and data were acquired as they performed 7 McKenzie low back exercises and 3 sitting posture positions. Engineered time series features were extracted from the data and used to train 9 models by using a 6-fold cross-validation approach, from which the best 2 models were selected for further study. In addition, a convolutional neural network was trained directly on the time series data. A feature importance analysis was performed to identify sensor locations and channels that contributed the most to the models. Finally, a subset of sensor locations and channels was included in a hyperparameter grid search to identify the optimal sensor configuration and best performing algorithms for exercise and posture classification. The final models were evaluated using the F₁ score in a 10-fold cross-validation approach.</p><p><strong>Results: </strong>In total, 19 healthy adults with no history of LBP each completed at least one full session of exercises and postures. Random forest and XGBoost (extreme gradient boosting) models performed the best out of the initial set of 9 engineered feature models. The optimal hardware configuration was identified as a 3-sensor setup-lower back, left thigh, and right ankle sensors with acceleration, gyroscope, and magnetometer channels. The XGBoost model achieved the highest exercise (F₁ score: mean 0.94, SD 0.03) and posture (F₁ score: mean 0.90, SD 0.11) classification scores. The convolutional neural network achieved similar results with the same sensor locations, using only the accelerometer and gyroscope channels for exercise classification (F₁ score: mean 0.94, SD 0.02) and the accelerometer channel alone for posture classification (F₁ score: mean 0.88, SD 0.07).</p><p><strong>Conclusions: </strong>This study demonstrates the potential of a 3-sensor lower body wearable solution (eg, smart pants) that can identify exercises in multiple planes and proper sitting postures, which is suitable for the treatment of LBP. This technology has the potential to improve the effectiveness of LBP rehabilitation by facilitating quantitative feedback, early problem diagnosis, and possible remote monito","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e38689"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assistive Robots for Patients With Amyotrophic Lateral Sclerosis: Exploratory Task-Based Evaluation Study With an Early-Stage Demonstrator.","authors":"Robert Klebbe,&nbsp;Stefan Scherzinger,&nbsp;Cornelia Eicher","doi":"10.2196/35304","DOIUrl":"https://doi.org/10.2196/35304","url":null,"abstract":"<p><strong>Background: </strong>Although robotic manipulators have great potential in promoting motor independence of people with motor impairments, only few systems are currently commercially available. In addition to technical, economic, and normative barriers, a key challenge for their distribution is the current lack of evidence regarding their usefulness, acceptance, and user-specific requirements.</p><p><strong>Objective: </strong>Against this background, a semiautonomous robot system was developed in the research and development project, robot-assisted services for individual and resource-oriented intensive and palliative care of people with amyotrophic lateral sclerosis (ROBINA), to support people with amyotrophic lateral sclerosis (ALS) in various everyday activities.</p><p><strong>Methods: </strong>The developed early-stage demonstrator was evaluated in a task-based laboratory study of 11 patients with ALS. On the basis of a multimethod design consisting of standardized questionnaires, open-ended questions, and observation protocols, participants were asked about its relevance to everyday life, usability, and design requirements.</p><p><strong>Results: </strong>Most participants considered the system to provide relevant support within the test scenarios and for their everyday life. On the basis of the System Usability Scale, the overall usability of the robot-assisted services for individual and resource-oriented intensive and palliative care of people with ALS system was rated as excellent, with a median of 90 (IQR 75-95) points. Moreover, 3 central areas of requirements for the development of semiautonomous robotic manipulators were identified and discussed: requirements for semiautonomous human-robot collaboration, requirements for user interfaces, and requirements for the adaptation of robotic capabilities regarding everyday life.</p><p><strong>Conclusions: </strong>Robotic manipulators can contribute to increase the autonomy of people with ALS. A key issue for future studies is how the existing ability level and the required robotic capabilities can be balanced to ensure both high user satisfaction and effective and efficient task performance.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e35304"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobility-Focused Physical Outcome Measures Over Telecommunication Technology (Zoom): Intra and Interrater Reliability Trial.","authors":"Marie-Louise Bird,&nbsp;Felix Peel,&nbsp;Matt Schmidt,&nbsp;Natalie A Fini,&nbsp;Emily Ramage,&nbsp;Brodie M Sakakibara,&nbsp;Dawn B Simpson,&nbsp;Carey Mather,&nbsp;Dominique A Cadilhac,&nbsp;Kiran D K Ahuja,&nbsp;Heather Bridgman,&nbsp;Coralie English","doi":"10.2196/38101","DOIUrl":"https://doi.org/10.2196/38101","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation provided via telehealth offers an alternative to currently limited in-person health care. Effective rehabilitation depends on accurate and relevant assessments that reliably measure changes in function over time. The reliability of a suite of relevant assessments to measure the impact of rehabilitation on physical function is unknown.</p><p><strong>Objective: </strong>We aimed to measure the intrarater reliability of mobility-focused physical outcome measures delivered via Zoom (a commonly used telecommunication platform) and interrater reliability, comparing Zoom with in-person measures.</p><p><strong>Methods: </strong>In this reliability trial, healthy volunteers were recruited to complete 7 mobility-focused outcome measures in view of a laptop, under instructions from a remotely based researcher who undertook the remote evaluations. An in-person researcher (providing the benchmark scores) concurrently recorded their scores. Interrater and intrarater reliability were assessed for Grip Strength, Functional Reach Test, 5-Time Sit to Stand, 3- and 4-Meter Walks and Timed Up and Go, using intraclass correlation coefficients (ICC) and Bland-Altman plots. These tests were chosen because they cover a wide array of physical mobility, strength, and balance constructs; require little to no assistance from a clinician; can be performed in the limits of a home environment; and are likely to be feasible over a telehealth delivery mode.</p><p><strong>Results: </strong>A total of 30 participants (mean age 36.2, SD 12.5 years; n=19, 63% male) completed all assessments. Interrater reliability was excellent for Grip Strength (ICC=0.99) and Functional Reach Test (ICC=0.99), good for 5-Time Sit to Stand (ICC=0.842) and 4-Meter Walk (ICC=0.76), moderate for Timed Up and Go (ICC=0.64), and poor for 3-Meter Walk (ICC=-0.46). Intrarater reliability, accessed by the remote researcher, was excellent for Grip Strength (ICC=0.91); good for Timed Up and Go, 3-Meter Walk, 4-Meter Walk, and Functional Reach (ICC=0.84-0.89); and moderate for 5-Time Sit to Stand (ICC=0.67). Although recorded simultaneously, the following time-based assessments were recorded as significantly longer via Zoom: 5-Time Sit to Stand (1.2 seconds), Timed Up and Go (1.0 seconds), and 3-Meter Walk (1.3 seconds).</p><p><strong>Conclusions: </strong>Untimed mobility-focused physical outcome measures have excellent interrater reliability between in-person and telehealth measurements. Timed outcome measures took approximately 1 second longer via Zoom, reducing the reliability of tests with a shorter duration. Small time differences favoring in-person attendance are of a similar magnitude to clinically important differences, indicating assessments undertaken using telecommunications technology (Zoom) cannot be compared directly with face-to-face delivery. This has implications for clinicians using blended (ie, some face-to-face and some via the internet) assess","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e38101"},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9446136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40629759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Virtual Reality Exercises at Home for Post-COVID-19 Condition: Cohort Study.","authors":"Tjitske Groenveld,&nbsp;Retze Achttien,&nbsp;Merlijn Smits,&nbsp;Marjan de Vries,&nbsp;Ron van Heerde,&nbsp;Bart Staal,&nbsp;Harry van Goor","doi":"10.2196/36836","DOIUrl":"https://doi.org/10.2196/36836","url":null,"abstract":"<p><strong>Background: </strong>Between 30% to 76% of COVID-19 patients have persistent physical and mental symptoms, sometimes up to 9 months after acute COVID-19. Current rehabilitation is mostly focused on the physical symptoms, whereas experts have agreed on the need for a biopsychosocial approach. A novel approach such as virtual reality (VR) rehabilitation at home might benefit patients and therapists, especially considering the expected rush of patients with post-COVID-19 condition needing rehabilitation.</p><p><strong>Objective: </strong>The aim of this study was to investigate the feasibility of self-administered VR exercises at home for post-COVID-19 condition.</p><p><strong>Methods: </strong>This was a single-arm feasibility study in an outpatient care setting. Patients who needed physiotherapy because of post-COVID-19 condition were included as determined by the treating physiotherapist. Participants performed VR physical exercises at home for a period of 6 weeks and were allowed to perform VR mental exercise through applications available on the VR platform to reduce stress and anxiety and promote cognitive functioning. The main outcomes were related to feasibility (ie, duration and frequency of VR use), safety (ie, adverse events), patient satisfaction, and reasons to withdraw. Physical performance, daily activities, cognitive functioning, anxiety and depression, and the quality of life were measured before and after.</p><p><strong>Results: </strong>In total, 48 patients were included; 1 (2%) patient did not start VR, and 7 (15%) patients withdrew, mostly due to dizziness. Almost 70% (33/47) of participants reported experiencing any adverse event during VR exercising. However, only 25% (9/36) recalled these events at the end of the intervention period. The majority (27/36, 75%) of the patients described VR as having a positive influence on their recovery, and the global satisfaction score was 67%. The average VR use was 30 minutes per session, 3-4 times a week for 3-6 weeks. The overall use of VR applications was almost equally distributed over the 3 sets of VR exercises (physical, relaxing, and cognitive). However, the use frequency of physical exercises seemed to decrease over time, whereas the use of cognitive and relaxation exercises remained stable. Physical performance and quality of life outcomes were significantly improved after 6 weeks.</p><p><strong>Conclusions: </strong>VR physical exercises at home is feasible and safe with good acceptance in a significant percentage of patient with post-COVID-19 condition.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04505761; https://clinicaltrials.gov/ct2/show/NCT04505761.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e36836"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40610405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility and Acceptability of a New Noninvasive Ventilatory Assist Device, Rest-Activity Cycler-Positive Airways Pressure, During Exercise in a Population of Healthy Adults: Cohort Study.","authors":"Julie Reeve,&nbsp;Sarah Mooney,&nbsp;Nicola Jepsen,&nbsp;David White","doi":"10.2196/35494","DOIUrl":"https://doi.org/10.2196/35494","url":null,"abstract":"<p><strong>Background: </strong>Noninvasive ventilation has been demonstrated to benefit people who have moderate to severe chronic obstructive pulmonary disease during acute exacerbations. Studies have begun to investigate the effectiveness of noninvasive ventilation during pulmonary rehabilitation to improve outcomes for people with chronic obstructive pulmonary disease; however, the lack of portability and humidification of these devices means their use is limited, especially when performing activities of daily living. A new prototype device, RACer-PAP (rest-activity cycler-positive airways pressure), delivers battery-operated positive airway pressure via a nasal interface while regulating nasal airway apportionment bias, removing the need for supplementary humidification. This device may offer people with chronic obstructive pulmonary disease an improved ability to participate in pulmonary rehabilitation and activities of daily living.</p><p><strong>Objective: </strong>To assess the feasibility of exercising with the RACer-PAP in situ and the acceptability of the device during exercise in normal, healthy individuals.</p><p><strong>Methods: </strong>A total of 15 healthy adults were invited to attend 2 exercise sessions, each 1 week apart. Sessions lasted approximately 1 hour and included 2 baseline 6-minute walk distance assessments, once with and once without the RACer-PAP in situ. Vital signs and spirometry results were monitored throughout, and spirometry was performed pre- and posttesting with RACer-PAP. Subjective questionnaires ascertained participant feedback on exercising with the device in situ.</p><p><strong>Results: </strong>Of the 15 initial participants, 14 (93%) completed both sessions. There were no adverse events associated with exercising with the device in situ. There were no differences in vital signs or 6-minute walk distance whether exercising with or without the device in situ. There were small increases in maximum dyspnea score (on the Borg scale) when exercising with the device in situ (median score 2.0, IQR 0.5-3.0, vs 3.0, IQR 2.0-3.25). There were small increases in forced vital capacity following exercise with the RACer-PAP. None of the participants reported symptoms associated with airway drying. Participant feedback provided recommendations for modifications for the next iteration of the device prior to piloting the device with people with chronic obstructive pulmonary disease.</p><p><strong>Conclusions: </strong>This study has shown RACer-PAP to be safe and feasible to use during exercise and has provided feedback for modifications to the device to improve its use during exercise. We now propose to consider the application of the device in a small pilot feasibility study to assess the safety, feasibility, and utility of the device in a population of people with moderate to severe chronic obstructive pulmonary disease.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry ACTR","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e35494"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40575028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mHealth Apps for Musculoskeletal Rehabilitation: Systematic Search in App Stores and Content Analysis.","authors":"Shíofra Ryan,&nbsp;Noirín Ní Chasaide,&nbsp;Shane O' Hanrahan,&nbsp;Darragh Corcoran,&nbsp;Brian Caulfield,&nbsp;Rob Argent","doi":"10.2196/34355","DOIUrl":"https://doi.org/10.2196/34355","url":null,"abstract":"<p><strong>Background: </strong>The number of mobile health (mHealth) apps released for musculoskeletal (MSK) injury treatment and self-management with home exercise programs (HEPs) has risen rapidly in recent years as digital health interventions are explored and researched in more detail. As this number grows, it is becoming increasingly difficult for users to navigate the market and select the most appropriate app for their use case. It is also unclear what features the developers of these apps are harnessing to support patient self-management and how they fit into clinical care pathways.</p><p><strong>Objective: </strong>The objective of this study was to scope the current market of mHealth apps for MSK rehabilitation and to report on their features, claims, evidence base, and functionalities.</p><p><strong>Methods: </strong>A cross-sectional study of apps for MSK rehabilitation was performed across the iTunes App Store and Google Play Store. Four search terms were used, namely, physiotherapy rehabilitation, physical therapy rehabilitation, rehabilitation exercise, and therapeutic exercise to identify apps, which were then cross-referenced against set selection criteria by 4 reviewers. Each reviewer, where possible, downloaded the app and accessed supplementary literature available on the product to assist in data extraction.</p><p><strong>Results: </strong>A total of 1322 apps were identified. After applying the inclusion and exclusion criteria and removing duplicates, 144 apps were included in the study. Over half (n=81, 56.3%) of the included apps had been released within the past 3 years. Three quarters (n=107, 74.3%) of the apps made no reference to evidence supporting the design or efficacy of the app, with only 11.1% (n=16) providing direct citations to research. Most of the apps did utilize exercise pictures (n=138, 95.8%) or videos (n=97, 67.4%); however, comparatively few harnessed additional features to encourage engagement and support self-management, such as an adherence log (n=66, 45.8%), communication portal (n=32, 22.2%), patient-reported outcome capture (n=36, 25%), or direct feedback (n=57, 39.6%). Of note and concern, many of these apps prescribed generic exercises (n=93, 64.6%) in the absence of individualized input to the user, with few providing specific patient education (n=43, 34%) and safety advice or disclaimers (n=38, 26.4%).</p><p><strong>Conclusions: </strong>The cohort of apps included in this study contained a large heterogeneity of features, so it is difficult for users to identify the most appropriate or effective app. Many apps are missing the opportunity to offer key features that could promote exercise adherence and encourage self-management in MSK rehabilitation. Furthermore, very few developers currently offering products on the market are providing evidence to support the design and efficacy of their technologies.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e34355"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40664650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Social Robot (LOVOT) for Persons With Dementia: Exploratory Study.","authors":"Birthe Dinesen,&nbsp;Helle Kidde Hansen,&nbsp;Gry Bruun Grønborg,&nbsp;Anne-Kirstine Dyrvig,&nbsp;Sofie Dalskov Leisted,&nbsp;Henrik Stenstrup,&nbsp;Cathrine Skov Schacksen,&nbsp;Claus Oestergaard","doi":"10.2196/36505","DOIUrl":"https://doi.org/10.2196/36505","url":null,"abstract":"<p><strong>Background: </strong>Approximately 50 million people worldwide are living with dementia. Social robots have been developed and tested to determine whether they improve the quality of life for persons with dementia. A new mobile social robot called LOVOT has artificial intelligence and sensor technologies built in. LOVOT, which is manufactured in Japan, has not yet been tested for use by persons with dementia.</p><p><strong>Objective: </strong>This study aimed to explore how the social robot LOVOT interacts with persons with dementia and how health care professionals experience working with LOVOT in their interaction with persons with dementia.</p><p><strong>Methods: </strong>The study was carried out at 3 nursing homes in Denmark, all with specialized units for persons with dementia. The interaction between the persons with dementia and LOVOT was tested in both individual sessions for 4 weeks and group sessions for 12 weeks. A total of 42 persons were included in the study, of which 12 were allocated to the individual sessions. A triangulation of data collection techniques was used: the World Health Organization-5 questionnaire, face scale, participant observation, and semistructured focus group interviews with health care professionals (n=3).</p><p><strong>Results: </strong>There were no clinically significant changes in the well-being of the persons with dementia followed in the individual or group interaction sessions over time. The results from the face scale showed that in both the individual and group sessions, persons with dementia tended to express more positive facial expressions after the sessions. Findings on how persons with dementia experienced their interaction with LOVOT can be stated in terms of the following themes: LOVOT opens up communication and interaction; provides entertainment; creates a breathing space; is accepted and creates joy; induces feelings of care; can create an overstimulation of feelings; is not accepted; is perceived as an animal; is perceived as being nondemanding; and prevents touch deprivation. Findings regarding the health care professionals' experiences using LOVOT were as follows: the artificial behavior seems natural; and it is a communication tool that can stimulate, create feelings of security, and open up communication. Our findings indicate that the social robot is a tool that can be used in interactions with persons with dementia.</p><p><strong>Conclusions: </strong>The LOVOT robot is the next generation of social robots with advanced artificial intelligence. The vast majority of persons with dementia accepted the social robot LOVOT. LOVOT had positive effects, opened up communication, and facilitated interpersonal interaction. Although LOVOT did not create noticeable effects on social well-being, it gave individual persons a respite from everyday life. Some residents were overstimulated by emotions after interacting with LOVOT. Health care professionals accepted the social robot and vie","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e36505"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40685957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed Reality Cognitive Orthosis to Support Older Adults in Achieving Their Daily Living Activities: Focus Group Study With Clinical Experts.","authors":"Amel Yaddaden,&nbsp;Guillaume Spalla,&nbsp;Charles Gouin-Vallerand,&nbsp;Patricia Briskie-Semeniuk,&nbsp;Nathalie Bier","doi":"10.2196/34983","DOIUrl":"https://doi.org/10.2196/34983","url":null,"abstract":"<p><strong>Background: </strong>Mixed reality is an emerging technology that allows us to blend virtual objects into the actual user's environment. This can be realized using head-mounted displays. Many recent studies have suggested the possibility of using this technology to support cognition in people with neurodegenerative disorders (NDs). However, most studies have explored improvements in cognition rather than in independence and safety during the accomplishment of daily living activities. Therefore, it is crucial to document the possibility of using mixed reality to support the independence of older adults in their daily lives.</p><p><strong>Objective: </strong>This study is part of a larger user-centered study of a cognitive orthosis using pure mixed reality to support the independence of people living with NDs. This study aimed to explore (the difficulties encountered by older adults with NDs in their daily life to ensure that pure mixed reality meets their needs, (the most effective interventions with this population to determine what types of assistance should be provided by pure mixed reality technology, how the pure mixed reality technology should provide assistance to promote aging in place, and the main facilitators of and barriers to the use of this technology.</p><p><strong>Methods: </strong>We conducted a descriptive, qualitative study. A total of 5 focus groups were completed with occupational therapists who had expertise in the disease and its functional impacts (N=29) to gather information. Each focus group met once for a 1-hour period. All sessions were held over a 3-month period. A semistructured interview guide was used. All group interviews were audiotaped with the consent of each participant to facilitate the data analysis. We conducted inductive qualitative analysis in four stages using a thematic analysis approach: full transcription of the audio recordings, first-order coding of the transcribed data, second-order coding from the first-order code list, and data reduction and matrix development.</p><p><strong>Results: </strong>The results suggested that the main difficulties encountered by this population were in remembering to complete tasks, initiating the tasks, and planning the tasks. Several interventions are used to improve the independence of this population, such as prevention, simplification or facilitation, adaptation, and compensation. The use of pure mixed reality in older adults with NDs to promote independence and safety at home is promising and may respond to several clinical functions identified by the participants. Finally, pure mixed reality has good potential for use in this population and involves certain facilitators and obstacles, such as resources, technical aspects, and social considerations.</p><p><strong>Conclusions: </strong>The cognitive orthosis that will be developed in light of this study will act as a proof of concept for the possibility of supporting people with NDs using pure mixed reali","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e34983"},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40522139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Viewpoint on the Quality of Digital Health Industry-Sponsored Research and Potential Threat to Patient Care (Preprint)","authors":"Timothy F. Marshall, J. Vandevender","doi":"10.2196/40980","DOIUrl":"https://doi.org/10.2196/40980","url":null,"abstract":"","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47118244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes After a Digital Musculoskeletal Program for Acute and Subacute Pain: Observational, Longitudinal Study With Comparison Group.","authors":"Grace Wang,&nbsp;Manshu Yang,&nbsp;Mindy Hong,&nbsp;Jeffrey Krauss,&nbsp;Jeannie F Bailey","doi":"10.2196/38214","DOIUrl":"https://doi.org/10.2196/38214","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation for musculoskeletal (MSK) conditions may produce similar or better outcomes than usual care, but most telerehabilitation studies address only chronic or postsurgical pain.</p><p><strong>Objective: </strong>We aimed to examine pain and function at 3, 6, and 12 weeks for individuals with acute and subacute MSK pain who took part in a digital MSK program versus a nonparticipant comparison group.</p><p><strong>Methods: </strong>We conducted an observational, longitudinal study with a nonparticipant comparison group. The intervention group had video visits with physical therapists who recommended exercise therapies and educational articles delivered via an app. Nonparticipants were those who were registered but unable to participate because their benefit coverage had not yet begun. We collected pain and function outcomes through surveys delivered at 3-, 6-, and 12-week follow-ups. We conducted descriptive analyses, unadjusted regression, and mixed effects regression adjusting for baseline characteristics, time as fixed effects, and a time*group interaction term.</p><p><strong>Results: </strong>The analysis included data from 675 nonparticipants and 262 intervention group participants. Compared to baseline, the intervention group showed significantly more pain improvement at 3, 6, and 12 weeks versus nonparticipants after adjusting for baseline factors. Specifically, the intervention group's pain scores decreased by 55.8% at 3 weeks versus baseline, 69.1% at 6 weeks, and 73% at 12 weeks. The intervention group's adjusted pain scores decreased from 43.7 (95% CI 41.1-46.2) at baseline to 19.3 (95% CI 16.8-21.8) at 3 weeks to 13.5 (95% CI 10.8-16.2) at 6 weeks to 11.8 (95% CI 9-14.6) at 12 weeks. In contrast, nonparticipants' pain scores decreased by 30.8% at 3 weeks versus baseline, 45.8% at 6 weeks, and 46.7% at 12 weeks. Nonparticipants' adjusted pain scores decreased from 43.8 (95% CI 42-45.5) at baseline to 30.3 (95% CI 27.1-33.5) at 3 weeks to 23.7 (95% CI 20-27.5) at 6 weeks to 23.3 (95% CI 19.6-27) at 12 weeks. After adjustments, the percentage of participants reporting that pain was better or much better at follow-up was significantly higher by 40.6% at 3 weeks, 31.4% at 6 weeks, and 31.2% at 12 weeks for intervention group participants versus nonparticipants. After adjustments, the percentage of participants with meaningful functional improvement at follow-up was significantly higher by 15.2% at 3 weeks and 24.6% at 12 weeks for intervention group participants versus nonparticipants.</p><p><strong>Conclusions: </strong>A digital MSK program may help to improve pain and function in the short term among those with acute and subacute MSK pain.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e38214"},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9274396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40404949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}