JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Evidence-Generated Sockets for Transtibial Prosthetic Limbs Compared With Conventional Computer-Aided Designs: A Multiple-Methods Study From the Patient's Perspective.","authors":"Florence Mbithi, Maggie Donovan-Hall, Jennifer Bramley, Joshua Steer, Charalambos Rossides, Peter Worsley, Chantel Ostler, Cheryl Metcalf, Dominic Hannett, Caroline Ward, Jack Kitchen, Sioned Steventon, Katy McIntosh, Shigong Guo, Helen Harvey, David Henderson Slater, Vijay Kolli, Alex Dickinson","doi":"10.2196/69962","DOIUrl":"10.2196/69962","url":null,"abstract":"<p><strong>Background: </strong>Personalized prosthetic socket design depends upon highly skilled prosthetists. They aim to balance functional human-prosthesis coupling with safe, comfortable load transmission from the prosthesis to the skeleton, through vulnerable skin and soft tissues. Both traditional plaster and computer-aided design and manufacturing (CAD/CAM) methods are iterative, and sharing knowledge is difficult. Evidence-generated (EG) sockets derived from past computer-aided socket design (CASD) records could provide a personalized starting point for limb fitting, potentially reducing time spent on basic design and enabling prosthetists to focus on more highly-skilled customization.</p><p><strong>Objective: </strong>This study aimed to assess the comfort of EG sockets, generated from past CASD records.</p><p><strong>Methods: </strong>A crossover trial compared EG sockets, derived from 163 previous transtibial devices, with conventional clinician-led CAD/CAM sockets. Noninferiority was assessed for the socket comfort score (SCS) outcome measure, and semistructured interviews provided in-depth user analysis. The setting was 3 UK National Health Service clinics, with 17 participants with 19 transtibial amputations.</p><p><strong>Results: </strong>EG sockets had no statistically significant difference in comfort compared with clinician-led control sockets (median SCS 8.6 for EG sockets and 8.8 for CAD/CAM controls; P=.43, effect size=0.05), but a lower variability in SCS across the group (95% CIs 8.0-9.0 for EG and 7.5-9.5 for CAD/CAM devices, respectively). Analysis of interviews revealed themes around fitting session experiences, similarities, and differences between the EG and CAD/CAM control sockets, and residual limb factors impacting perceptions of socket comfort. These provided insights into the participants' experience of the study and the value of expert prosthetist input in socket design.</p><p><strong>Conclusions: </strong>EG sockets demonstrated noninferiority to conventional clinical CASD practice in terms of socket comfort. Both quantitative and qualitative results indicated how clinician input remains essential and is valued by prosthesis users. Work is underway to incorporate the EG sockets into CASD software such that they can act as a digital starting point for modification by expert clinicians at fitting, potentially reducing time spent on basic design, enabling prosthetists to focus on more highly-skilled customization and co-design with their patients.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69962"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972425","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":"Development of Goal-Achievement Support App to Assist Children and Families in Participating in Meaningful Occupations: Content Validation Using Delphi Method.","authors":"Koki Kura, Jumpei Oba, Satoru Amano, Kayoko Takahashi","doi":"10.2196/73430","DOIUrl":"10.2196/73430","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Occupational therapy has highlighted the necessity for planning and executing interventions in collaboration with clients, families, and caregivers to facilitate their progress. Thus, in pediatric occupational therapy, it is essential to position the family as a primary client and to actively involve them in the intervention process. These interventions often incorporate tools that facilitate parental engagement in home-based activities. However, no tools have been specifically designed to support parents comprehensively in achieving their parenting goals in everyday situations. To address this gap, we developed a mobile app called the Children's Occupation Support Mobile System (COSMO) to support occupational therapists, children, and parents in a collaborative manner to achieve intervention goals in daily life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study is to develop the COSMO and validate its content in terms of legibility, visibility, and accessibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was conducted in two stages: (1) designing a prototype of COSMO and (2) validating its content using the Delphi method. The prototype was developed based on a conceptual model of parenting strategies, which was derived from interviews with mothers raising children with developmental disabilities. This study included 10 Japanese pediatric occupational therapists, who were selected using convenience sampling to ensure diversity and heterogeneity in attributes. The Delphi survey was conducted entirely through a web-based questionnaire emailed to the experts. Participants rated their agreement with each item on a 5-point Likert scale. A mean item score of ≥3.75 (75%) indicated consensus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prototype was designed through a series of 13 one-hour meetings held monthly. The functional framework of COSMO was structured into four core components based on previous research: (1) collaborative goal setting, (2) home strategy-an action plan to achieve goals, (3) self-reflection-a record of implemented strategies, and (4) progress reports-data storage for tracking outcomes. For validating the content, the 2 Delphi rounds resulted in a total mean score of 4.44 for legibility, 4.86 for visibility, and 4.84 for accessibility. In the free-text responses, there were references to improvements in the wording and to the burden of writing the reflections. Therefore, the wording was revised to avoid jargon and use plain language. The burden of COSMO use was reduced by simplifying the use process by incorporating optional inputs for some of its functions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;COSMO was developed as a comprehensive tool to integrate functions while aiming to reduce the burden on parents. This may reduce resistance to app use and make it easier for more parents to use it. Future studies should evaluate the generalizability and effectiveness of the prototype as an intervention. Limitatio","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e73430"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972185","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":"Challenges and Opportunities of the Human-Centered Design Approach: Case Study Development of an Assistive Device for the Navigation of Persons With Visual Impairment.","authors":"Mario Andres Chavarria, Luisa María Ortiz-Escobar, Bladimir Bacca-Cortes, Victor Romero-Cano, Isabella Villota, Jhon Kevin Muñoz Peña, José Roberto Londoño Sánchez, Oscar Campo, Silvan Suter, Jhon Jairo Cabrera-López, Maria Fernanda Sanchez Patiño, Eduardo Francisco Caicedo-Bravo, Michael Stein, Samia Hurst, Klaus Schönenberger, Minerva Rivas Velarde","doi":"10.2196/70694","DOIUrl":"10.2196/70694","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Visual impairment (VI) significantly impacts quality of life, particularly in autonomous pedestrian navigation. Limitations in independent navigation lead to frustration, diminished confidence, and risks to bodily integrity for individuals with VI. In Colombia, the pilot country of this study, approximately 2 million people live with some form of visual disability. Globally, only 1 in 10 people requiring assistive devices have access to them, with factors such as deficient product design stemming from limited knowledge of user expectations, local needs, and environmental constraints, posing significant challenges, particularly in low- and middle-income countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the feasibility and limitations of applying the human-centered design (HCD) principles outlined by the International Organization for Standardization (ISO) 9241-210:2019 standard in assistive technology (AT) development for individuals with VI in Colombia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed a prototype navigation device using the HCD principles, emphasizing a thorough analysis of user needs and environmental contexts. The project leveraged multidisciplinary collaboration to address challenges associated with user engagement and design adaptability while managing legal and bureaucratic constraints. The navigation system integrates artificial intelligence algorithms, specifically developed by the research team as part of this work, to enhance its adaptability and responsiveness to diverse environments. The development process featured iterative prototyping cycles, incorporating user feedback at each stage, all within the boundaries of applicable regulatory frameworks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The development and evaluation of the initial prototype highlighted both the feasibility and key limitations of applying the ISO 9241-210:2019 HCD principles in AT for individuals with VI in the Colombian context. The prototype met several user-defined expectations by prioritizing affordability; extended battery life; autonomy in internet-constrained environments; and improved ergonomics, concealability, aesthetics, and obstacle detection. These achievements demonstrated the potential of HCD to guide context-sensitive innovation. However, the process also revealed significant barriers: limited legal and procedural clarity for engaging users in design phases, difficulties navigating ethics committees, and a lack of practical guidance within the ISO standard itself. These constraints, compounded by challenges in interdisciplinary collaboration, limited the depth and adaptability of user involvement across development stages.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Implementing HCD principles in AT development shows promise for creating effective and affordable solutions tailored to user needs and contexts. However, legislative and methodological barriers must be addressed to fully realize HCD's potential.","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70694"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875610","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":"How AI-Based Digital Rehabilitation Improves End-User Adherence: Rapid Review.","authors":"Mahsa MohammadNamdar, Michael Lowery Wilson, Kari-Pekka Murtonen, Eeva Aartolahti, Michael Oduor, Katariina Korniloff","doi":"10.2196/69763","DOIUrl":"10.2196/69763","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI) in rehabilitation technology is transforming traditional methods, focusing on personalization and improved outcomes. The growing area of AI in digital rehabilitation (DR) emphasizes the critical role of end-user compliance with rehabilitation programs. Analyzing how AI-driven DR tools can boost this compliance is vital for creating sustainable practices and tackling future challenges.</p><p><strong>Objective: </strong>This study seeks to assess how AI-based DR can improve the end-user compliance or adherence to rehabilitation.</p><p><strong>Methods: </strong>Following the updated recommendations for the Cochrane rapid review methods guidance and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search strategy was led in PubMed, which yielded 922 records, resulting in 6 papers included in this study.</p><p><strong>Results: </strong>The reviewed studies identified 6 key ways in which AI enhances end-user compliance in rehabilitation. The most prevalent method (in 4 studies) involves motivating and engaging users through features like exercise tracking and motivational content. The second method, also noted in 4 studies, focuses on improving communication and information exchange between health care providers and users. Personalized solutions tailored to individual cognitive styles and attitudes were highlighted in 3 studies. Ease of use and system usability, affecting user acceptability, emerged in 2 studies. Additionally, daily notifications, alerts, and reminders were identified as strategies to promote compliance, also noted in 2 studies. While 5 studies looked at AI's role in improving adherence, 1 study specifically assessed AI's capability for objective compliance measurement, contrasting it with traditional subjective self-reports.</p><p><strong>Conclusions: </strong>Our results could be especially relevant and beneficial for rethinking rehabilitation practices and devising effective strategies for the integration of AI in the rehabilitation field, aimed at enhancing end-user adherence to the rehabilitation regimen.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69763"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856675","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 Novel QR Code-Based Solution for Secure Electronic Health Record Transfer in Venous Thromboembolism Home Rehabilitation Management: Algorithm Development and Validation.","authors":"Changzhen Li, Zhigeng Jin, Fei Wang, Zheqi Zhang, Binbin Liu, Yutao Guo","doi":"10.2196/69230","DOIUrl":"10.2196/69230","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Venous thromboembolism (VTE) is a common vascular disorder requiring extended anticoagulation therapy postdischarge to reduce recurrence risk. Home rehabilitation management systems that use electronic health records from hospital care provide opportunities for continuous patient monitoring. However, transferring medical data from clinical to home settings raises significant concerns about privacy and security. Conventional methods such as manual data entry, optical character recognition, and dedicated data transmission lines face notable technical and operational challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop a QR code-based security transmission algorithm using Avro and byte pair encoding (BPE). The algorithm supports the secure creation and transfer of out-of-hospital health records by enabling patients to scan QR codes via a dedicated mobile app, ensuring data security and user privacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between January and October 2024, 300 hospitalized patients with VTE were recruited at the Sixth Medical Center of the Chinese PLA General Hospital. Post discharge, participants used a home rehabilitation app tailored for VTE management. The QR code-based security transmission algorithm was developed to securely transfer in-hospital electronic health records to the out-of-hospital app. It uses BPE, Avro, and Gzip for optimized data compression and uses ChaCha20 and BLAKE3 for encryption and authentication. Specifically, BPE tokenizes medical text, while Avro serializes JSON (JavaScript Object Notation) objects, contributing to data encryption. A proprietary tokenizer was trained, and compression efficiency was evaluated using a \"Performance Benchmark Dataset.\" Comparative analyses were conducted to assess the compression efficiency of JSON serialization methods (Avro and ASN.1 [Abstract Syntax Notation One]), and tokenization algorithms (BPE and unigram).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The dataset consisted of JSON files from 300 patients, averaging 240.1 fields per file (range 89-623) and 7095 bytes in size (range 2748-17,425 bytes). Using the BPE + Avro + Gzip algorithm, the average file size was reduced to 1048 bytes, achieving a compression ratio of 6.67. This was 1.82 times more efficient than traditional Gzip compression (average file size: 1907 bytes; compression ratio: 3.66; P&lt;.001). For Chinese medical text tokenization, BPE outperformed unigram with a compression ratio of 4.68 versus 4.55 (P&lt;.001). Avro and ASN.1 demonstrated comparable compression ratios of 2.57 and 2.59, respectively, when used alone (P=.30). However, Avro combined with BPE and Gzip significantly outperformed ASN.1, achieving compression ratios of 6.67 versus 5.21 (P&lt;.001). Additionally, 84.7% (254/300) of patients needed to scan only 1 QR code, requiring an average of 3.1 seconds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The QR code-based security transmission algorithm using Avro and BPE efficie","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69230"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822789","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":"Assessing Physical Therapists' Expectations and Experiences With an Automated Rehabilitation System Using Technology Acceptance Model: Multiple Methods Pilot Study.","authors":"Cynthia Williams, Lindsay Toth, Raine Osborne, Chloe E Bailey, Aishwarya Joshi","doi":"10.2196/67440","DOIUrl":"10.2196/67440","url":null,"abstract":"<p><strong>Background: </strong>Wearable sensor systems maximize visual and clinical feedback for physical therapists to enhance patient outcomes in rehabilitation medicine. However, physical therapists must adopt and accept new technologies for full integration into routine care to advance the use of technology in clinical care. Their role in technology design is critical in adopting and implementing technology. Interprofessional collaboration should be supported in the design of rehabilitation-assisted technologies.</p><p><strong>Objective: </strong>We used the established tenets of the Technology Acceptance Model to describe physical therapists' expectations and experiences before and after using a novel wearable system in outpatient physical therapy.</p><p><strong>Methods: </strong>This multiple methods pilot study used a comparative pre-post survey and a qualitative semistructured focus group study design. Using purposive sampling, we recruited outpatient physical therapists to pilot the novel wearable technology, describe their expectations and experiences, and participate in a semistructured focus group discussion conducted to gather training and user experience information.</p><p><strong>Results: </strong>The study sample consisted of 5 physical therapists with an average age of 38.8 (SD 6.9) years and a work experience average of 12 (SD 7.7) years. Presurvey data show favorable expectations for usefulness and ease of use; however, favorability in both factors decreased after use. For perceived usefulness, all responses moved in the less favorable direction; mean difference -4.4 (SD 3.21); P=.04. All but 2 responses moved in the less favorable direction for overall perceived ease of use; mean difference -4.8 (SD 1.79); P=.04. Themed responses to open-ended questions in the postsurvey were feedback, setup time, accuracy, performance, and enhanced functional activities. Inductive content analysis of the focus group responses resulted in the following themes: system training, system benefits, system challenges, physical therapist perception of patients, and suggestions for improvement. The expectation for frequency of use decreased pre- to postexperience by 53% (mean -22, SD 14.40; P=.04).</p><p><strong>Conclusions: </strong>The Technology Acceptance Model-based survey responses and focus group themes outcomes demonstrated that physical therapists' expectations for using new technology were not met. Engaging physical therapists in piloting novel wearable technology highlights the importance of physical therapist engagement in developing, refining, and implementing wearable devices for rehabilitation.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e67440"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800504","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":"Investigating the Acceptance and Implementation Conditions of Telerehabilitation in Germany Among Patients and Health Care Professionals: Qualitative Interview Study.","authors":"Monica-Diana Podar, Susanne Stampa, Oliver Razum, Christoph Dockweiler","doi":"10.2196/68766","DOIUrl":"10.2196/68766","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation has become increasingly important worldwide, as the COVID-19 pandemic forced many rehabilitation centers to change their daily care routine and find new ways to provide medical rehabilitation and aftercare.</p><p><strong>Objective: </strong>This study aims to investigate the acceptance and implementation conditions of telerehabilitation in Germany, particularly following the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted qualitative semistructured interviews with patients (n=9) and health care professionals (n=8) between September 2023 and January 2024. To explore individual and structural barriers to and facilitators of telerehabilitation adoption, we used the extended unified theory of acceptance and use of technology and the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>Patients and health care professionals perceived telerehabilitation as positive, mainly due to its flexibility and accessibility. Patients expressed high acceptance levels, anticipating health benefits, although they found it challenging to familiarize themselves with the technology and establish routines. Health care professionals highlighted the need for adequate resources (financial, time, and personnel) and management support to implement telerehabilitation successfully. Both groups saw higher acceptance and cost coverage of telerehabilitation services as essential for successful implementation and use in Germany.</p><p><strong>Conclusions: </strong>This study identified institutional barriers, such as concerns about resource availability, team communication, and initial resistance among health care staff to the introduction of new technologies. At an individual level, we found that patients struggled with routine establishment and that digital and in-person support from institutions and peers could mitigate this challenge. Implementing a hybrid approach and improving funding and approval processes would enhance telerehabilitation integration in the German health care sector.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68766"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765605","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":"Biomechanical and Kinematic Gait Analysis in Lower Limb Amputees: Cross-Sectional Study.","authors":"Natali Olaya Mira, Luz Marina Gómez Hernández, Carolina Viloria Barragán, Manuela Monsalve Montes, Isabel Cristina Soto Cardona","doi":"10.2196/67022","DOIUrl":"10.2196/67022","url":null,"abstract":"<p><strong>Background: </strong>The quantification of gait parameters in amputees facilitates the assessment of their performance with prosthetic devices. These parameters often depend on measurements based on anatomical aspects that vary across different types of lower limb amputations.</p><p><strong>Objective: </strong>This study aimed to investigate body weight distribution, and gait symmetry, quality, and propulsion, as well as pelvic kinematics in the amputee population.</p><p><strong>Methods: </strong>The EcoWalk baropodometry platform was used to measure plantar pressure, and the G-Walk inertial sensor was used for accelerometry measurements in 29 unilateral lower limb amputees.</p><p><strong>Results: </strong>Values were estimated for each variable under analysis, and the findings were categorized by the level of amputation. All variables exhibited normal distribution within each group under analysis , except for the symmetry index in above-knee (AK) amputees (P=.03). Regarding the body weight distribution (P=.11), velocity (P≥.99), propulsion (P=.38), and quality index (P=.10) of the amputated limb; no significant differences were observed between the AK and below-knee (BK) amputees. The most significant deviation was noted in pelvic obliquity, which was greater in AK amputees compared to BK amputees.</p><p><strong>Conclusions: </strong>The values reported for the variables under analysis may enable the establishment of more precise reference levels for the amputee population, thereby contributing to a more accurate diagnostic process and aiding prosthetic fitting.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e67022"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745361","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":"Perspectives From Canadian People With Visual Impairments in Everyday Environments Outside the Home: Qualitative Insights for Assistive Technology Development.","authors":"Prajjol Raj Puri, Andréanne Coutaller, Frédérique Gwade, Soutongnoma Safiata Kabore, Deborah Annan, Joseph Paul Nemargut","doi":"10.2196/73380","DOIUrl":"10.2196/73380","url":null,"abstract":"<p><strong>Background: </strong>Despite the abundance of assistive devices available, the accomplishment of many everyday tasks remains complex for people with visual impairments. While several studies have been conducted to identify the obstacles encountered when moving around outdoors, current knowledge is less abundant when it comes to the difficulties encountered in complex, indoor environments.</p><p><strong>Objective: </strong>This study aimed to identify the most important obstacles and facilitators encountered in everyday indoor travel environments outside the home for people with low vision and blindness.</p><p><strong>Methods: </strong>Data were collected from 20 participants with varying levels of vision from several cities across Canada in 2 web-based focus groups in both English and French. Using open-ended questions, participants shared obstacles and facilitators experienced or imagined during independent navigation in the following scenarios: coffee shop, hospital, big-box store, party with friends, and bus rides. Thematic analysis was conducted, and responses were either categorized as barriers or facilitators for each scenario. These were ranked by all participants via email according to their perceived importance in completing each scenario.</p><p><strong>Results: </strong>Across scenarios, the principal barriers to perceived success were inaccessible signage, difficulties walking around, problems finding a specific location, and unsuccessful interactions with others. The main facilitators across scenarios were helpful interactions with others, planning, accessible signage, and websites. The use of mobile apps was discussed but ranked as less important by participants. Though similar among the French and English groups, the rankings of the different facilitators and barriers were largely scenario-specific. The most barriers were mentioned in the coffee shop (n=8), followed by the department store (n=7) and bus or metro (n=7) for the English group, whereas the most barriers were in the department store (n=9), followed by the hospital or clinic (n=7) and coffee shop (n=6) for the French group.</p><p><strong>Conclusions: </strong>Though promising technologies have been developed to resolve some of the issues surrounding indoor navigation for people with visual impairments, they were not perceived as helpful as some other traditional methods of assistance, such as asking for help, by our participants. For the successful incorporation of indoor navigation technologies, it is important to understand how they integrate into the experience of people as they move in these dynamic environments. The successful use of technology is only possible if the physical environment permits and facilitates independent navigation.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e73380"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745362","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":"Sociotechnical Adaptation of Telerehabilitation in Rehabilitation Practice: Survey Among Rehabilitation Professionals.","authors":"Tuija Partanen, Riitta Seppänen-Järvelä, Sinikka Hiekkala, Jari Lindh","doi":"10.2196/74296","DOIUrl":"10.2196/74296","url":null,"abstract":"<p><strong>Background: </strong>Both rehabilitation practice and rehabilitation professionals' work have been transformed by the adoption of different technological solutions. Sociotechnical theory can be used to analyze the adoption of technologies in rehabilitation practice.</p><p><strong>Objective: </strong>This study aimed to enhance the understanding of the sociotechnical perspective of telerehabilitation (TR) in rehabilitation practice, as well as the understanding of how sociotechnical frameworks can be used to examine the implementation of telerehabilitation in outpatient rehabilitation.</p><p><strong>Methods: </strong>A survey of rehabilitation professionals (N=629) was conducted in a Finnish outpatient rehabilitation setting. Data from 5 open-ended questions were analyzed using inductive, deductive, and abductive qualitative content analysis. An analysis matrix formed from the Fit between Individuals, Tasks, and Technology (FITT) and the Fit between Individuals, Tasks, Technology, and Environment (FITTE) frameworks was used.</p><p><strong>Results: </strong>Deductive analysis revealed that in individual-task fit, professionals' and clients' adequate skills, support for participation, and a positive attitude were essential. The task-technology fit highlighted the need for the professionals' familiarization, changes in methods and materials, and collaboration with clients and their close associates and networks. The individual-task fit revealed that professionals found TR tasks to be more complex than those in in-person practice and that TR increased professionals' perceived workload and clients' need for personal contact, especially during the familiarization phase. Our findings suggest that certain dimensions of the FITTE framework need to be specified in order to better understand the sociotechnical adaptation of TR.</p><p><strong>Conclusions: </strong>We propose an extension to create the Fit between Individual, Task, Technology, Interactive Sociotechnical Environment, and Organizational and Sociopolitical Context (FITTIO) framework, which provides conceptual tools for making contextual interpretations of the adoption of TR in rehabilitation settings. This study increases understanding of the sociotechnical nature of TR, which can be used in the adoption of technological solutions in rehabilitation practice.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e74296"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733669","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}