JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Integration of Ambient Assisted Living Technologies in Older Adults' Care: Lessons Learned from a Longitudinal Study.","authors":"Oteng Ntsweng, Martin Kodyš, Zhi Quan Ong, Fang Zhou, Antoine de Marassé-Enouf, Ibrahim Sadek, Hamdi Aloulou, Sharon Swee-Li Tan, Mounir Mokhtari","doi":"10.2196/57989","DOIUrl":"https://doi.org/10.2196/57989","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has added an impetus to an already growing trend around the use of Ambient Assisted Living (AAL) technologies to support frail seniors who live alone. The challenge, however, is that systematic research on the long-term usage of AAL technologies remains in its nascent stages, leaving gaps in understanding of the predictors that contribute to the routine embedding of AAL technologies in seniors' care.</p><p><strong>Objective: </strong>This viewpoint shares key lessons from a longitudinal study on the routine embedding of AAL technologies in senior care within a hitherto understudied Southeast Asian context. Our objective was to design and deploy an ambient assisted living system termed Ubiquitous Service MAnagement and Reasoning archiTecture (Ubismart), evaluate its impact on older adults' quality of life (QoL), and distill lessons to inform the sustainable and culturally sensitive adoption of AAL technologies in similar settings.</p><p><strong>Methods: </strong>We conducted an in-depth case study using a mixed-methods design. First, we designed and deployed Ubismart to unobtrusively monitor and visualize older adults' activities of daily living (ADLs). To assess changes in QoL, we administered a simplified, gamified version of the validated OPQoL questionnaire. Finally, we conducted semi-structured interviews with older adults and their caregivers to triangulate the quantitative findings and explore evolving perceptions of the technology and its integration into daily routines.</p><p><strong>Results: </strong>Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being and (2) leisure and social activities following the AAL intervention. Other QoL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to \"insurance\" or a silent companion. However, the impact on social relationships was paradoxical-some seniors felt more cared for, while others perceived a decline in in-person visits. This paradox highlights the complexities of technology's role in caregiving, as it may simultaneously enhance feelings of safety while unintentionally diminishing social connection for some seniors.</p><p><strong>Conclusions: </strong>Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being and (2) leisure and social activities following the AAL intervention. Other QoL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to \"insurance\" or a silent companion. However, the impact on social relationships was paradoxical-some seniors felt more ca","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081182","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":"Beneficial Effects of the Novel Digital Incentive Spirometer Device and Incentive Spirometer in Patients Undergoing Open-Heart Surgery: Randomized Controlled Trial.","authors":"Kornanong Yuenyongchaiwat, Somrudee Harnmanop, Lucksanaporn Mahawong, Nattapoomin Ruangphet, Kannika Jeangubon, Chaopraya Nenmanee, Chitima Kulchanarat, Opas Satdhabudha","doi":"10.2196/68158","DOIUrl":"10.2196/68158","url":null,"abstract":"<p><strong>Background: </strong>The number of patients undergoing open-heart surgery (OHS) is persistently increasing. Additionally, postoperative pulmonary complications have been reported after OHS, and an incentive spirometer has been suggested to prevent postoperative pulmonary complications. However, no commercial incentive spirometer provides the precise inhalation volume. We developed a digital incentive spirometer (DIS) that displays the relevant data.</p><p><strong>Objective: </strong>In this study, we aimed to explore the beneficial effects of a DIS on respiratory function in patients who underwent OHS.</p><p><strong>Methods: </strong>A randomized controlled trial was designed with 32 patients scheduled for OHS: 16 individuals each were assigned to the DIS and the flow-oriented incentive spirometer (ie, Triflow incentive spirometer) groups, respectively. The patients were requested to use the DIS and Triflow incentive spirometer 15 times/set, two sets/day, from day 1 to 5 postextubation. All participants underwent lung function and respiratory muscle strength assessments prior to OHS and on day 5 postextubation postoperatively. For comparison between and within the groups, we performed an intention-to-treat analysis with a two-way mixed analysis of variance.</p><p><strong>Results: </strong>In both the DIS and Triflow incentive spirometer groups, pulmonary function parameters and maximal respiratory pressure were markedly reduced on day 5 postextubation when compared with those prior to OHS (P<.05). There were no significant differences in pulmonary function or respiratory muscle strength between the two groups (P>.05).</p><p><strong>Conclusions: </strong>Pulmonary function and respiratory muscle strength did not differ significantly between the DIS and Triflow incentive spirometer groups among patients who underwent OHS.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68158"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048387","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":"Family Members' Experiences of a Person-Centered Information and Communication Technology-Supported Intervention for Stroke Rehabilitation (F@ce 2.0): Qualitative Analysis.","authors":"Gunilla Eriksson, Kajsa Söderhielm, Malin Erneby, Susanne Guidetti","doi":"10.2196/69878","DOIUrl":"https://doi.org/10.2196/69878","url":null,"abstract":"<p><strong>Background: </strong>Stroke often leads to long-term effects on daily activities and participation. Consequences impact not only stroke survivors but also their close networks, and capturing their experiences is crucial for the development of effective interventions. F@ce 2.0 is a person-centered, information and communication technology (ICT)-supported stroke rehabilitation intervention currently being evaluated.</p><p><strong>Objective: </strong>This study aims to describe family members' experiences of the F@ce 2.0 intervention from the perspective of being a caregiver to a stroke survivor.</p><p><strong>Methods: </strong>Participants were family members (n=7) of stroke survivors participating in the intervention. Semistructured interviews were conducted at 2 time points, postintervention and 6 months postbaseline, resulting in a total of 13 interviews. Data was analyzed using qualitative inductive content analysis.</p><p><strong>Results: </strong>An overarching theme was developed from 4 categories. The main theme was the potential of F@ce 2.0 as a support for family members of stroke survivors in the sudden change of life. The categories were: dialogue and partnership with the F@ce 2.0 team, resuming daily activities lowers the demand for family support, support and involvement through the ICT component of F@ce 2.0, and engagement in F@ce 2.0, leading to suggestions for development.</p><p><strong>Conclusions: </strong>This study aligns with previous research delineating the effects of stroke on family members of stroke survivors. Participants highlighted the positive impact of the focus on daily activities within the intervention. Furthermore, the ICT component was perceived as a support in structuring rehabilitation. Participants, however, suggested further development, both in terms of content and technology.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69878"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031733","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":"Advances in Infant Cry Paralinguistic Classification-Methods, Implementation, and Applications: Systematic Review.","authors":"Geofrey Owino, Bernard Shibwabo","doi":"10.2196/69457","DOIUrl":"10.2196/69457","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Effective communication is essential for human interaction; yet, infants can only express their needs through various types of suggestive cries. Traditional approaches of interpreting infant cries are often subjective, inconsistent, and slow, leaving gaps in timely, precise caregiving responses. A precise interpretation of infant cries can potentially provide valuable insights into the infant's health, needs, and well-being, enabling prompt medical or caregiving actions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study seeks to systematically review the advancements in methods, coverage, deployment schemes, and applications of infant cry classification over the last 24 years. The review focuses on the different infant cry classification techniques, feature extraction methods, and practical applications. Furthermore, we aimed to identify recent trends and directions in the field of infant cry signal processing to address both academic and practical needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature review was conducted using 9 electronic databases: Cochrane Database of Systematic Reviews, JSTOR, Web of Science Core Collection, Scopus, PubMed, ACM, MEDLINE, IEEE Xplore, and Google Scholar. A total of 5904 search results were initially retrieved, with 126 studies meeting the eligibility criteria after screening by 2 independent reviewers. The methodological quality of these studies was assessed using the Cochrane risk of bias tool (version 2; RoB2), with 92% (n=116) of the studies indicating a low risk of bias and 8% (n=10) of the studies showing some concerns regarding bias. The overall quality assessment was performed using TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) guidelines. The data analysis was conducted using R (version 3.64; R Foundation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Notable advancements in infant cry classification methods were realized, particularly from 2019 onward, using machine learning, deep learning, and hybrid approaches. Common audio features included Mel-frequency cepstral coefficients, spectrograms, pitch, duration, intensity, formants, 0-crossing rate, and chroma. Deployment methods included mobile apps and web-based platforms for real-time analysis, with 90% (n=113) of the remaining models remaining undeployed to real-world applications. Denoising techniques and federated learning were limitedly used to enhance model robustness and ensure data confidentiality from 5% (n=6) of the studies. Some of the practical applications spanned health care monitoring, diagnostics, and caregiver support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The evolution of infant cry classification methods has progressed from traditional classical statistical methods to machine learning models but with minimal considerations of data privacy, confidentiality, and ultimate deployment to practical use. Further research is thus proposed to develop standardize","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e69457"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754975","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 Importance of Telerehabilitation and Future Directions for the Field.","authors":"Sarah Munce","doi":"10.2196/76153","DOIUrl":"10.2196/76153","url":null,"abstract":"<p><p>During the COVID-19 pandemic, telerehabilitation was critical to providing ongoing care for people with impairments or disabilities, and it remains frequently used and popular after the pandemic. Telerehabilitation has been shown to be feasible and effective in a variety of conditions, including chronic heart failure and coronary artery disease, stroke, multiple sclerosis, and spinal cord injuries, with adverse events being rare. This editorial identifies important areas and future directions for the field, including implementation considerations in the postpandemic context, issues of access and equity, and emerging innovations and personalized care. The development and implementation of this knowledge will ensure that individuals with disabilities and impairments will continue to receive effective, safe, and person-driven care remotely.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e76153"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050960","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":"Wheelchair Servicing for Older Adults: Cross-Sectional Study.","authors":"Anand Mhatre, Abigail Dumm, Muyun Zhao, Lorena Parra Rodriguez","doi":"10.2196/66472","DOIUrl":"https://doi.org/10.2196/66472","url":null,"abstract":"<p><strong>Background: </strong>Wheelchairs are assistive mobility devices known to experience frequent part failures and breakdowns within 6 months of regular use. No tools or technologies exist to monitor the wheelchairs' condition or usage and inform stakeholders and users regarding when or how often they need to undergo servicing to avoid critical part failure.</p><p><strong>Objective: </strong>We aimed to test the association between wheelchair usage and manual wheelchair damage, part failures, and consequences for older wheelchair users and evaluate their preferences for a new wheelchair servicing technology.</p><p><strong>Methods: </strong>A cross-sectional study was performed with older manual wheelchair users atInstituto Nacional de Geriatría in Mexico. Demographic data, wheelchair information, failure counts, and preferences for new technology (sensor and smartphone app for servicing) were collected using surveys. Road shocks experienced by the wheelchair were collected for a week using a sensor.</p><p><strong>Results: </strong>Ten participants (mean [SD] age, 78.8 [11.8] y; 8 female and 2 male) participated. Seven experienced an average (SD) of 2.86 (1.36) self-reported part failures. Road shocks correlated with self-reported loose brake failures (r(8)=0.58, P=.09), the damaged condition of tires (r(8)=0.61, P=.1), and the damaged condition of brakes (r(8)=0.58, P=.099). No consequences were reported. Part failures increased as self-maintenance occurrences increased (r(9)=0.67, P=.04). More than 8 participants responded that they would like to monitor the wheelchair's condition using the new technology and purchase it at an average (SD) price of US $28.95 (18.13).</p><p><strong>Conclusions: </strong>In this study, the association between wheelchair usage and failures showed that data-driven wheelchair inspection schedules should be determined through a collaborative approach involving researchers and stakeholders in wheelchair repair provision and older adult users. Older adults are interested in using new technology to engage in wheelchair servicing.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66472"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019917","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":"Mainstream Smart Home Technology-Based Intervention to Enhance Functional Independence in Individuals With Complex Physical Disabilities: Single-Group Pre-Post Feasibility Study.","authors":"Dan Ding, Lindsey Morris, Gina Novario, Andrea Fairman, Kacey Roehrich, Palma Foschi Walko, Jessica Boateng","doi":"10.2196/70855","DOIUrl":"https://doi.org/10.2196/70855","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mainstream smart home technologies (MSHTs), such as home automation devices and smart speakers, are becoming more powerful, affordable, and integrated into daily life. While not designed for individuals with disabilities, MSHT has the potential to serve as assistive technology to enhance their independence and participation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study aims to describe a comprehensive MSHT-based intervention named ASSIST (Autonomy, Safety, and Social Integration via Smart Technologies) and evaluate its feasibility in enhancing the functional independence of individuals with complex physical disabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;ASSIST is a time-limited intervention with a design based on the human activity assistive technology model, emphasizing client-centered goals and prioritizing individual needs. The intervention follows a structured assistive technology service delivery process that includes 2 assessment sessions to determine technology recommendations, installation and setup of the recommended technology, and up to 8 training sessions. An occupational therapist led the intervention, supported by a contractor and a technologist. Feasibility was evaluated through several measures: (1) the ASSIST Functional Performance Index, which quantifies the number of tasks transitioned from requiring assistance to independent completion and from higher levels of assistance or effort to lower levels; (2) pre- and postintervention measures of perceived task performance and satisfaction using a 10-point scale; (3) the number and types of tasks successfully addressed, along with the costs of devices and installation services; and (4) training effectiveness using the Goal Attainment Scale (GAS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 17 powered wheelchair users with complex physical disabilities completed the study with 100% session attendance. Across participants, 127 tasks were addressed, with 2 to 10 tasks at an average cost of US $3308 (SD US $1192) per participant. Of these tasks, 95 (74.8%) transitioned from requiring partial or complete assistance to independent completion, while 24 (18.9%) either improved from requiring complete to partial assistance or, if originally performed independently, required reduced effort. Only 8 (6.3%) tasks showed no changes. All training goals, except for 2, were achieved at or above the expected level, with a baseline average GAS score of 22.6 (SD 3.5) and a posttraining average GAS score of 77.2 (SD 4.5). Perceived task performance and satisfaction showed significant improvement, with performance score increasing from a baseline mean of 2.6 (SD 1.2) to 8.8 (SD 1.0; P&lt;.001) and satisfaction score rising from an average of 2.9 (SD 1.3) to 9.0 (SD 0.9; P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The ASSIST intervention demonstrated the immediate benefits of enhancing functional independence and satisfaction with MSHT among individuals with complex physical disab","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70855"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015450","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":"Design Requirements for Cardiac Telerehabilitation Technologies Supporting Athlete Values: Qualitative Interview Study.","authors":"Irina Bianca Șerban, Lonneke Fruytier, Steven Houben, Sara Colombo, Danny van de Sande, Hareld Kemps, Aarnout Brombacher","doi":"10.2196/62986","DOIUrl":"https://doi.org/10.2196/62986","url":null,"abstract":"<p><strong>Background: </strong>Cardiac telerehabilitation (CTR) interventions can provide accessible and affordable remote rehabilitation services. However, as cardiac rehabilitation (CR) primarily targets inactive patients, little is known about the experiences with CR of highly active patients (ie, recreational athletes or, simply, athletes) with established coronary artery disease. Consequently, existing CTR interventions do not address the specific needs of the athletic subpopulation. Understanding the needs and values of athletes is crucial for designing meaningful CTR interventions that enhance user acceptance and engagement, thereby facilitating effective rehabilitation for this patient subgroup.</p><p><strong>Objective: </strong>This study aimed to inform the design of technologies that facilitate CTR for athletes. We intended to identify athletes' values related to CR, including health and sports tracking, as well as high-level requirements for technologies that can facilitate the CTR of athletes according to the identified values.</p><p><strong>Methods: </strong>We used value-sensitive design with a human-centric design approach to elicit design requirements for CTR that can serve athletes with established coronary artery disease. To identify athletes' values, we conducted 25 value-oriented semistructured interviews with 15 athletic patients and 10 health care professionals involved in CR programs. In a second phase, we conducted 6 card-sorting focus group sessions with 13 patients and 7 health care professionals to identify desired CTR features. Finally, we derived high-level CTR technology requirements connected to the athletes' needs and values.</p><p><strong>Results: </strong>We defined 12 athlete values divided into 3 categories: body centric, care centric, and data and technology centric. We clustered findings from the card-sorting activity into CTR technology requirements, such as remotely monitored sport-specific training and training data representations next to clinical limitations, and paired them with corresponding values.</p><p><strong>Conclusions: </strong>Athletes have distinct values and health goals in CR compared to general populations targeted by CTR interventions. Designing patient-centric CTR interventions that address these needs is crucial to support optimal recovery, safe return to sports, and adherence to CTR technologies in the home environment.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e62986"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037591","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":"Physiotherapists' User Acceptance of a Lower Limb Robotic Exoskeleton in Specialized Rehabilitation: Qualitative Exploratory Study.","authors":"Anstein Olimb Hillkirk, Kirsti Skavberg Roaldsen, Hege Mari Johnsen","doi":"10.2196/68233","DOIUrl":"https://doi.org/10.2196/68233","url":null,"abstract":"<p><strong>Background: </strong>Robotic lower limb exoskeletons have emerged as promising tools in the clinical rehabilitation of patients with lower limb paralysis due to neurological disease, stroke, or spinal cord injury. Identified benefits in gait function rehabilitation include improved gait function, cardiovascular effects, enhanced training quality, patient motivation, and reduced physical and psychological workload for therapists. Despite the identified benefits, the successful adoption of this technology largely depends on therapists' user acceptance.</p><p><strong>Objective: </strong>This study aims to explore physiotherapists' perceptions of using robot-assisted lower-limb gait training in specialized neurological rehabilitation using the unified theory of acceptance and use of technology framework.</p><p><strong>Methods: </strong>A qualitative, exploratory research design with a deductive approach was used. Semistructured interviews were conducted with 7 expert physiotherapists in a Norwegian specialized rehabilitation hospital. Data collection and analysis were guided by the unified theory of acceptance and use of technology framework.</p><p><strong>Results: </strong>The physiotherapists' use of lower limb exoskeletons was greatly influenced by perceived benefits for patients or challenges, such as usability issues, the time required for adjustment to each patient, and the lack of personnel resources to facilitate their use. Thus, perceived usefulness and facilitating conditions (or lack thereof) had a great influence on the physiotherapists' intentions to use and the actual use of the exoskeleton.</p><p><strong>Conclusions: </strong>This study identified several factors influencing the physiotherapists' acceptance and integration of the lower limb exoskeleton. Available resources, such as time and personnel, were emphasized as important factors to increase the use of the exoskeleton in specialized rehabilitation. Our findings may inform service providers and engineers in specialized neurological rehabilitation settings.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68233"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053233","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":"Virtual Reality Respiratory Biofeedback in an Outpatient Pediatric Pain Rehabilitation Program: Mixed Methods Pilot Study.","authors":"Kristin Recker, Julia Silliman, Karolina Gifford, Parth Patel, Lisgelia Santana, Aimee K Hildenbrand, Shreela Palit, Rachel Wasserman","doi":"10.2196/66352","DOIUrl":"https://doi.org/10.2196/66352","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic pain in adolescents is a significant and growing concern, as it can have negative implications on physical and psychosocial development. Management can be complicated by the increasing risks associated with opioid misuse, highlighting the need for effective nonpharmacological interventions. Biofeedback is an empirically supported behavioral intervention for chronic pain that targets the self-regulation of physiological responses. Virtual reality (VR) is a novel delivery method for biofeedback that could serve as an engaging and effective platform for adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The goal of this study was to assess the feasibility, acceptability, and preliminary effectiveness of integrating a VR-delivered respiratory biofeedback intervention into an outpatient pediatric pain rehabilitation program (PPRP) for adolescents with chronic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this pilot study, we recruited 9 participants from those enrolled in the PPRP at Nemours Children's Hospital. Participants underwent 2 VR respiratory biofeedback sessions per week over a 4-week period using AppliedVR's \"RelieVRx\" program. Feasibility was defined as &gt;60% of eligible patients enrolling with at least 80% of VR sessions completed. Acceptability was assessed via validated acceptability questionnaires, with high acceptability defined as an average acceptability rating score &gt;3 on a 5-point Likert scale. Open-ended responses were analyzed via qualitative analysis. Preliminary effectiveness was assessed with questionnaires measuring the quality of life (Pediatric Quality of Life Inventory [PedsQL]) and level of pain interference in daily activities (Functional Disability Inventory) before and after participation in the pain program. Finally, heart rate (HR) and blood pressure (BP) were measured before and after each VR session.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 14 eligible PPRP patients, 9 (64%) enrolled in the VR respiratory biofeedback study, and 7 (77% of study participants) completed at least 80% of biofeedback sessions. Participants reported high acceptability with average session ratings ranging from 3.89 to 4.16 on post-VR program questionnaires. Of 224 open-ended responses, participants reported changes in stress and somatic symptoms (ie, pain distraction and breathing regulation). There was a statistically significant increase in the average physical functioning score of the PedsQL among participants (P=.01) from pre- to postparticipation in the overall pain program. The cohort's average emotional functioning score of the PedsQL also increased, though this change was not statistically significant (P=.17). Participants' Functional Disability Inventory scores significantly decreased from an average of 25.1 to 11 from before to after the pain program (P=.002). There were no significant differences between pre- versus post-BP or HR for any session. However, decreased BP and HR were observed across most ses","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66352"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042376","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}