JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"A Method for Custom-Contoured Cushion Fabrication Based on Pressure Mapping for Wheelchair Users to Prevent Pressure Ulcers: Feasibility Quasi-Experimental Study.","authors":"Alma De León-Hernández, Adriana Martínez-Hernández, Isabel Bolivar-Tellería, Andrea Bosch-Sánchez, María Fernanda Cabrera-Padilla, Carlos Omar López-López","doi":"10.2196/68612","DOIUrl":"10.2196/68612","url":null,"abstract":"<p><strong>Background: </strong>Pressure ulcers constitute a major health care burden, characterized by significant morbidity, diminished quality of life, and elevated treatment costs. Wheelchair users are predisposed to pressure ulcers due to sustained ischial and sacral interface pressures resulting from prolonged periods of sitting. Implementation of pressure-relieving interventions, including specialized seating systems engineered to redistribute load and augment the weight-bearing surface area, is critical for mitigating the risk of pressure ulcers.</p><p><strong>Objective: </strong>This study aimed to evaluate a methodology for the custom fabrication of pressure relief cushions, through the user-cushion interface pressure mapping to reduce high-pressure areas and increase contact area in wheelchair users.</p><p><strong>Methods: </strong>First, a validation study was carried out with 7 healthy volunteers. The pressure was determined with an FSA sensor (BodiTrak BT1510, Vista Medical Manufactures), and the cushion profile was obtained through a linear relation with pressure values. In the second phase, 10 cushions for wheelchair users were manufactured and tested. The resulting data from buttock pressure using a flat foam, Jay X2 (gel-foam), ROHO high profile (air), and customed-contoured cushions were analyzed and compared using the following 4 variables: peak pressure, peak pressure index, mean pressure, and contact area.</p><p><strong>Results: </strong>In the validation study, the statistically significant difference between the flat and the custom-contoured cushion showed a better performance in pressure relief for the custom cushion (mean pressure 27.3, SD 4.5 mm Hg and 34.6, SD 3.5 mm Hg; P<.001). Regarding the study with wheelchair users, custom-contoured cushions had lower peak pressure (mean 91.3, SD 36 mm Hg), peak pressure index (mean 69.5, SD 33.7 mm Hg), and mean pressure (34.2, SD 17.4 mm Hg) against flat, Jay X2, and ROHO high profile cushions (P<.005). The contact area (mean 1457.6, SD 254.1 cm2) was greater for the contoured cushion (P<.001) than for flat and ROHO high profile (Permobile) cushions; nevertheless, it was not significantly different from Jay X2 (P=.59).</p><p><strong>Conclusions: </strong>The main finding is that the buttock pressure mapping method produces custom-contoured cushions that, compared with commercial cushions, have good pressure distribution and increased contact area. These results suggest that pressure mapping is a good alternative for manufacturing affordable custom-contoured cushions that can prevent the development of pressure ulcers.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68612"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129064","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":"Exploring Compassionate Care in Virtual Rehabilitation: Qualitative Study.","authors":"Parminder Flora, Angela Tobia, Lee Verweel, Bernice Lau, Janet Campbell, Arezoo Eshraghi, Steven Dilkas, Roger Goldstein, Patricia Raulino, Crystal MacKay","doi":"10.2196/59157","DOIUrl":"10.2196/59157","url":null,"abstract":"<p><strong>Background: </strong>Virtually delivered health care services can offer numerous benefits, and the demand for virtual care continues to grow among subgroups facing mobility challenges. The experience of compassion in health care is linked to patient satisfaction and clinical outcomes; however, this link in virtual rehabilitation settings is underexplored.</p><p><strong>Objective: </strong>The objectives of this study were to explore what compassionate care means to rehabilitation patients in a virtual rehabilitation context and explore patients' experiences of how the technology associated with virtual rehabilitation impacted their experience of care.</p><p><strong>Methods: </strong>We conducted one-on-one semistructured qualitative interviews with patients with limb loss and chronic obstructive pulmonary disease. A reflexive thematic analysis approach was used to generate domain summaries and initial themes across the sample. Themes were generated following analytic work over a series of discussions within the research team.</p><p><strong>Results: </strong>Sixteen interviews were conducted. Four themes illustrating participants' perceptions of compassionate care were generated: (1) features of compassionate care include feeling valued, connected, and cared for by the health care provider; (2) threats to compassionate care in virtual rehabilitation; (3) facilitating compassion in virtual rehabilitation through preparation; and (4) benefits of virtual care.</p><p><strong>Conclusions: </strong>Patient perceptions of compassionate care in a virtual rehabilitation setting may be impacted by the behaviors and communication of providers. Provider training and preparation and the personal connections formed with their patients may impact compassionate care experiences.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e59157"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129065","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":"Stakeholders and Contextual Factors in the Implementation of Assistive Robotic Arms for Persons With Tetraplegia: Deductive Content Analysis of Focus Group Interviews.","authors":"Vera Fosbrooke, Marco Riguzzi, Anja M Raab","doi":"10.2196/65759","DOIUrl":"10.2196/65759","url":null,"abstract":"<p><strong>Background: </strong>Tetraplegia imposes significant challenges on affected individuals, caregivers, and health care systems. Assistive technologies (ATs) such as assistive robotic arms have been shown to improve the quality of life of persons with tetraplegia, fostering independence in daily activities and reducing caregiver burden. Despite potential benefits, the integration of AT innovations into daily life remains difficult. Implementation science offers a systematic approach to bridge this know-do gap.</p><p><strong>Objective: </strong>This study aimed to (1) identify and involve relevant stakeholders; (2) identify relevant contextual factors (barriers and facilitators); and (3) suggest a general outlook for the implementation of AT, specifically an assistive robotic arm, into the everyday private lives of individuals with tetraplegia in Switzerland.</p><p><strong>Methods: </strong>A qualitative design was used, involving 3 semistructured online focus group interviews with 8 stakeholder groups, including persons with tetraplegia as well as those who could provide perspectives on engineering or technology, legal matters, nursing or care, therapy, social counseling, social insurance, and political considerations. The interviews were analyzed using the Focus Group Illustration Mapping tool, and the data were aligned with the domains of the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>3 focus group interviews comprising 22 participants were conducted, and data were mapped onto 21 constructs across the Consolidated Framework for Implementation Research domains. Identified barriers were customization to users' needs, safety concerns, and financing issues for the high AT costs. The collaboration with different stakeholders, including those who provided perspectives on political engagement, proved crucial. Identified facilitators included the enhancement of autonomy for persons with tetraplegia, improvement of quality of life, reduction of caregiver dependency, and addressing health care labor shortages. The implementation outlook involved the formation of an experienced team and the development of an implementation plan using hybrid type 1 and type 2 designs that incorporate both qualitative and quantitative implementation and innovation outcomes.</p><p><strong>Conclusions: </strong>Robotic arms offer promising benefits in terms of improved participation for users, while high costs and regulatory complexities as to who will assume these costs limit their implementation. These findings highlight the complexities involved in implementing AT innovations and the importance of addressing contextual factors. A specific framework for the implementation of AT is needed to ensure the successful integration in Switzerland and other countries with comparable social and health insurance systems.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65759"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081073","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":"Validation of Gait Kinematics With Ramp and Stair Ascent and Descent Revealed by Markerless Motion Capture in Simulated Living Space: Test-Retest Reliability Study.","authors":"Daiki Shimotori, Kenji Kato, Tatsuya Yoshimi, Izumi Kondo","doi":"10.2196/66886","DOIUrl":"10.2196/66886","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an increasing demand for markerless motion capture systems, which are being widely used in biomechanical and clinical research. Furthermore, by using a markerless motion capture system in a laboratory environment that mimics living spaces, the data acquired on various activities of daily living, such as level walking, ramp walking, and stair ascent and descent, should more closely resemble that of real-life activities. However, the absolute reliability of gait parameters in this context is still unclear.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the reliability of a markerless motion capture system in assessing the ascent and descent of ramps and stairs during walking in a simulated living space.</p><p><strong>Methods: </strong>A total of 21 healthy participants performed level walking, ramp and stair ascent and descent on two separate days, with at least a 24-hour interval between sessions. Joint angles were measured using 27 synchronized cameras with a markerless motion capture application, Theia3D (Theia Markerless Inc), and analyzed in Visual3d for all planes of motion at the hip-, knee-, and ankle-joints. The absolute reliability of day-to-day reproducibility was assessed using full-curve analysis (root mean square difference [RMSD]) and discrete point analysis of gait events using the standard error of measurement (SEM). SEM was calculated only for level walking and ramp ascent and descent, where gait events were correctly detected.</p><p><strong>Results: </strong>The SEM values for level walking and ramp ascent and descent were all below the 5-degree threshold. However, while RMSD values were generally below 5°, this threshold was exceeded for knee-joint flexion-extension angles during ramp ascent and stair ascent (5.07° and 5.64°, respectively).</p><p><strong>Conclusions: </strong>The markerless motion capture system in the living laboratory setting demonstrated a high degree of accuracy for various environments and gait types. The low SEM values obtained indicate good reliability for joint angle measurements across different days. The slightly higher RMSD values for knee-joint angles during ramp and stair ascent may reflect the system's ability to capture the adaptations in joint kinematics in response to changes in gait conditions. These measurements in a living laboratory environment validated the absolute reliability of various gait parameters not only in level walking but also in ramp and stair ascent and descent. The findings suggest potential clinical applications and research opportunities, including the development of assistive devices and robots, using markerless motion capture in more natural living situations, rather than in controlled environments.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66886"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081168","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":"Patients' Expectations for App-Based Therapy in Knee Osteoarthritis: User-Centered Design Approach.","authors":"Pika Krištof Mirt, Karmen Erjavec, Sabina Krsnik, Petra Kotnik, Hussein Mohsen","doi":"10.2196/64607","DOIUrl":"10.2196/64607","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Knee osteoarthritis (KOA) requires long-term treatment that faces significant barriers, including inadequate physiotherapy services, especially in Slovenia and comparable European countries. Mobile health apps offer a promising solution to improve accessibility and adherence to KOA treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to identify expectations of patients with KOA for app-based therapy, determine the functional requirements, and assess the main barriers and benefits of using mobile apps for KOA management. It also examined these factors about demographic data (gender, age, and education level) and motivation to perform knee exercises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods approach was used, integrating quantitative data from a structured questionnaire and qualitative data from in-depth interviews. The purposive sample comprised 82 patients with symptomatic KOA graded 1-3 on the Kellgren-Lawrence scale, excluding those with cognitive impairments, wheelchair dependency, significant comorbidities, or language barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis revealed that 53.7% (44/82) of patients preferred smartphones, while 40.2% (33/82) favored PCs for remote KOA management, citing accessibility and convenience. Exercise videos received the highest rating (µ=9.45), followed by goal setting and tracking (µ=8.95) and regular e-messages (µ=8.83). Telephone consultations with physiotherapists were also highly valued (µ=8.41). Significant differences were observed in the perceived importance of key disease information (F9=2.077; P=.04) and exercise videos (F9=2.788; P=.05) based on motivation levels but not by gender, age, or education. Perceptions of the appropriate duration of physical activity varied with motivation levels (F9=2.490; P=.02) but not with demographic factors. Men rated ease of use (4.93 vs 4.71; F1=3.961; P=.05) and the clarity of the exercise flow display higher than women. The most significant barrier was inaccurate disease information (µ=3.96), with notable differences across age groups. Younger participants (younger than 40 years) and those aged 51-60 years expressed concerns about time management and information accuracy. Patients highlighted the ability to rewatch exercises as a key app feature, while time efficiency and improved access to physiotherapists were highly valued for convenience. Enhanced communication and accurate information were essential for building trust and ensuring effective treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Mobile health apps for KOA management should be designed with a user-centered approach, prioritizing accessibility, motivation, and effective communication. Key functionalities include high-quality exercise videos, goal setting, symptom tracking, and regular electronic reminders. Mitigating user-reported barriers and integrating age-specific adaptations can enhance adherence and therapeutic outcomes. The findings highlig","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e64607"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081070","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":"Co-Designed Digital Device for Tracking Rehabilitation Dosage in a Clinical Environment After Stroke: Mixed Methods Validity and Feasibility Study.","authors":"Fiona Boyd, Gillian Sweeney, Mark Barber, Elaine Forrest, Mark Dunlop, Andrew Kerr","doi":"10.2196/68129","DOIUrl":"10.2196/68129","url":null,"abstract":"<p><strong>Background: </strong>In 2023, the National Clinical Guidelines for Stroke revised the recommended daily multidisciplinary therapy dose from 45 minutes per therapy to 3 hours of therapy overall. To monitor the achievement of these guidelines, there is a need for accurate measurement. This study introduces a novel co-designed digital dosage tracking system that uses Near Field Communication technology to log rehabilitation activities and demonstrates its feasibility and accuracy in a clinical setting through comparison with the current clinical method of manual recording.</p><p><strong>Objective: </strong>This study aimed to assess the validity, feasibility, and usability of a novel co-designed digital tracker using Near Field Communication technology to automatically log rehabilitation dosage in people with stroke history, providing an objective and low-burden solution for clinical environments.</p><p><strong>Methods: </strong>This pilot mixed methods study included 2 phases. Phase 1 involved a usability trial with 9 participants conducted at a university research center, assessing usability with the System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI). Phase 2 consisted of a clinical trial in a National Health Service stroke ward with 15 inpatients, comparing the digital tracker with manual therapist recordings for validity and feasibility using paired t tests, Cohen d, and Bland-Altman plots. An acceptable discrepancy range was set at ±5%-10%.</p><p><strong>Results: </strong>The digital tracker demonstrated high usability with a mean SUS score of 91.43 (SD 9.53) and strong user satisfaction (IMI score 6.29/7, SD 1.50). Clinical trial results showed a strong agreement between the digital and manual methods (t206=-1.60; P=.11; Cohen d=-0.06), with a small mean time discrepancy of 1.23 (SD 11.01) minutes across 207 activities. The Bland-Altman plot indicated good accuracy and consistency between methods, with limits of agreement within the clinically acceptable range.</p><p><strong>Conclusions: </strong>The co-designed digital tracker has been shown to agree with a manual method for recording rehabilitation dosage. This development presents the opportunity for objective, automated, and low-burden recording of rehabilitation dose to support prescription, monitoring, and research.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68129"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081046","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":"Machine Learning Clinical Decision Support for Interdisciplinary Multimodal Chronic Musculoskeletal Pain Treatment: Prospective Pilot Study of Patient Assessment and Prognostic Profile Validation.","authors":"Fredrick Zmudzki, Rob J E M Smeets, Jan S Groenewegen, Erik van der Graaff","doi":"10.2196/65890","DOIUrl":"10.2196/65890","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain (CMP) impacts around 20% of people globally, resulting in patients living with pain, fatigue, restricted social and employment capacity, and reduced quality of life. Interdisciplinary multimodal pain treatment (IMPT) programs have been shown to provide positive and sustained outcomes where all other interventions have failed. IMPT programs combined with multidimensional machine learning predictive patient profiles aim to improve clinical decision support and personalized patient assessments, potentially leading to better treatment outcomes.</p><p><strong>Objective: </strong>We aimed to investigate integrating machine learning with IMPT programs and its potential contribution to clinical decision support and treatment outcomes for patients with CMP.</p><p><strong>Methods: </strong>This prospective pilot study used a machine learning prognostic patient profile of 7 outcome measures across 4 clinically relevant domains, including activity or disability, pain, fatigue, and quality of life. Prognostic profiles were created for new IMPT patients in the Netherlands in November 2023 (N=17). New summary indicators were developed, including defined categories for positive, negative, and mixed prognostic profiles; an accuracy indicator with high, medium, and low levels based on weighted true- or false-positive values; and an indicator for consistently positive or negative outcomes. The consolidated reporting guidelines checklist for prognostic machine learning modeling studies was completed to provide transparency of data quality, model development methodology, and validation.</p><p><strong>Results: </strong>The machine learning IMPT prognostic patient profiles demonstrated high accuracy and consistency in predicting patient outcomes. The profile, combined with extended new prognostic summary indicators, provided improved identification of patients with predicted positive, negative, and mixed outcomes, supporting more comprehensive assessment. Overall, 82.4% (14/17) of prognostic patient profiles were consistent with clinician assessments. Notably, clinician case notes indicated the stratified prognostic profiles were directly discussed with around half (8/17, 47.1%) of patients. Clinicians found the prognostic patient profiles helpful in 88.2% (15/17) of initial IMPT assessments to support shared clinician and patient decision-making and discussion of individualized treatment planning.</p><p><strong>Conclusions: </strong>Machine learning prognostic patient profiles showed promising contributions for IMPT clinical decision support and improving treatment outcomes for patients with CMP. Further research is needed to validate these findings in larger, more diverse populations.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65890"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056853","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":"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}