JMIR Rehabilitation and Assistive Technologies最新文献

{"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}

{"title":"Understanding Patient and Physiotherapist Requirements for a Personalized Automated Smartphone Telemonitored App for Posttotal Knee Arthroplasty Rehabilitation: Qualitative Study.","authors":"Eleanor Shuxian Chew, Aileen Eugenia Scully, Samanth Shi-Man Koh, Ee-Lin Woon, Juanita Krysten Miao-Shi Low, Yu-Heng Kwan, John Wei-Ming Tan, Yong-Hao Pua, Celia Ia-Choo Tan, Luke Jonathan Haseler","doi":"10.2196/59688","DOIUrl":"https://doi.org/10.2196/59688","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is a cost-effective surgical intervention for painful knee osteoarthritis in older adults, but postsurgery rehabilitation access is limited. Telerehabilitation offers a solution, but existing models require significant therapist involvement and a costly setup. A personalized smartphone-based automated program could be a cost-effective alternative.</p><p><strong>Objective: </strong>This study aimed to understand the requirements of both patients and physiotherapists in developing an automated telemonitored rehabilitation smartphone app for individuals undergoing TKA. To ensure uptake and long-term sustainability, this study adopted a person-based approach.</p><p><strong>Methods: </strong>A multistakeholder qualitative study of user needs was conducted. Physiotherapists and patients who underwent TKA were recruited via purposive sampling. Individual in-depth, hour-long interviews were conducted via Zoom by an experienced, trained female interviewer with a Master of Arts in Sociology. Data were audio-recorded and transcribed by the same interviewer. Two reviewers (ESC and SSK) independently analyzed the data using thematic analysis, with data triangulation achieved through cross-checking of data sources by 3 reviewers (ESC, SSK, and AES). Interviews were conducted to data saturation.</p><p><strong>Results: </strong>Six patients and 4 physiotherapists participated. For the patient interface, patients emphasized ease of use and specified features like a search function and multilingual options. For the physiotherapist interface, physiotherapists stated ease of accessing patient data and outcome measures for effective monitoring as important. Both patients and physiotherapists highlighted the need for timely, condition-specific information, supplemented by visual aids to support exercises, pain management, and recovery goals. They also stressed the significance of progress tracking, feedback, and the ability to access health care professionals for reassurance. Motivational features, including reminders, prompts, and exercise logs, were recommended to improve adherence. Both groups similarly identified the need for initial training to ensure confident use of the app.</p><p><strong>Conclusions: </strong>This study provided insights into the requirements of potential end users of a smartphone app for automated telemonitored rehabilitation following TKA. This is useful for steering the development of a user-centric smartphone app.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e59688"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032455","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 Effectiveness of Telerehabilitation in Managing Pain, Strength, and Balance in Adult Patients With Knee Osteoarthritis: Systematic Review.","authors":"Theodora Plavoukou, Michail Iosifidis, Georgios Papagiannis, Dimitrios Stasinopoulos, Georgios Georgoudis","doi":"10.2196/72466","DOIUrl":"10.2196/72466","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Knee osteoarthritis (KOA) is a chronic, degenerative joint disease characterized by pain, stiffness, and functional impairment, significantly affecting mobility and quality of life. Traditional rehabilitation, mainly through in-person physiotherapy, is widely recommended for KOA management. However, access to these services is often limited due to geographic, financial, and mobility constraints. Telerehabilitation has emerged as an alternative, providing remote rehabilitation through digital platforms. Despite its increasing adoption, its effectiveness in improving key functional parameters such as pain, strength, and balance remains uncertain. While previous studies have focused primarily on pain relief and overall functional improvement, a broader assessment of its impact on mobility and fall prevention is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review examines the effectiveness of telerehabilitation in improving pain, strength, and balance in adults with KOA compared with traditional rehabilitation or no intervention. In addition, it evaluates the impact of different telerehabilitation models, such as therapist-guided versus self-managed programs, and explores the feasibility of integrating telerehabilitation as an alternative in KOA management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of 4 databases (PubMed, PEDro, Cochrane, and Scopus) was conducted to identify randomized controlled trials (RCTs) published from May 2004 to May 2024. Inclusion criteria consisted of adults with KOA, evaluation of telerehabilitation either as a stand-alone intervention or in comparison to traditional rehabilitation or no intervention, and measurement of at least one primary outcome (pain, strength, or balance). A total of 2 independent reviewers assessed the risk of bias using validated tools. Due to variations in intervention programs and assessment methods, a narrative synthesis was performed instead of a meta-analysis. The review followed established guidelines, and data extraction was conducted using appropriate software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 6 RCTs (N=581 participants) met the inclusion criteria. The results indicate that telerehabilitation effectively reduces pain and improves strength and balance, although the extent of benefits varies. Some studies reported similar pain reductions between telerehabilitation and traditional rehabilitation, while others highlighted greater functional improvements in telerehabilitation groups. Therapist-guided telerehabilitation was associated with higher adherence rates and better functional outcomes compared with self-managed programs. The risk of bias assessment showed that most studies were of moderate to good quality, though common issues included selection bias, performance bias, and participant attrition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Telerehabilitation is a promising alternative for KOA management, especially for individuals fa","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e72466"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812685","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":"Assessment of Pelvic Motion During Single-Leg Weight-Bearing Tasks Using Smartphone Sensors: Validity Study.","authors":"Yu Xi, Zhongsheng Li, Surendran Vatatheeswaran, Valter Devecchi, Alessio Gallina","doi":"10.2196/65342","DOIUrl":"10.2196/65342","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinicians and athletic training specialists often assess the performance of single-leg, weight-bearing tasks to monitor rehabilitation progress and guide exercise progression. Some of the key metrics assessed are excessive pelvic motion, balance, and duration of each repetition of the exercise. Motion can be objectively characterized using motion capture (MOCAP); however, MOCAP is often not available in clinics due to the high costs and complexity of the analyses. Smartphones have built-in sensors that can be used to measure changes in body segment orientation and acceleration, which may make them a more feasible and affordable technology to use in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to determine if, compared to gold-standard MOCAP, smartphone sensors can provide valid measures of pelvic orientation, acceleration, and repetition duration during single-leg tasks in healthy individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Overall, 52 healthy participants performed single-leg squats and step-down tasks from heights of 15 and 20 cm. Pelvic motion was assessed using MOCAP and a smartphone placed over the sacrum. The MATLAB (MathWorks) mobile app was used to collect smartphone acceleration and orientation data. Individual repetitions of each exercise were manually identified, and the following outcomes were extracted: duration of the repetition, mediolateral acceleration, and 3D pelvic orientation at peak squat. Validity was assessed by comparing metrics assessed with a smartphone and MOCAP using intraclass correlation coefficients (ICCs) and paired Wilcoxon tests. Differences between tasks were compared using 1-way ANOVA or the Friedman test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across the 3 single-leg tasks, smartphone estimates demonstrated consistently high agreement with the MOCAP for all metrics (ICC point estimates: &gt;0.8 for mediolateral acceleration and frontal plane orientation; &gt;0.9 for squat duration and orientation on the sagittal and transverse plane). Bias was identified for most outcomes (multiple P&lt;.001). Both smartphone and MOCAP recordings identified clear differences between tasks, with step-down tasks usually requiring larger changes in pelvic orientation and larger mediolateral sways. Duration did not differ between tasks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite a consistent bias, the smartphone demonstrated good to excellent validity relative to gold-standard MOCAP for most outcomes. This demonstrates that smartphones offer an accessible and affordable tool to objectively characterize pelvic motion during different single-leg weight-bearing tasks in healthy participants. Together with earlier reports of good between-day reliability of similar measures during single-leg squats, our results suggest that smartphone sensors can be used to assess and monitor single-leg task performance. Future studies should investigate whether smartphone sensors can aid in the assessment and treatme","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65342"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765000","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":"Validity of TongueFit: A Laboratory-Based Study.","authors":"Rizky Kusuma Wardhani, Luh Karunia Wahyuni, Widjajalaksmi Kusumaningsih, Sarworini Bagio Budiardjo, Prasandhya Astagiri Yusuf, Sri Mardjiati Mei Wulan, Aria Kekalih, Titis Prawitasari, Sawitri Darmiati, Boya Nugraha","doi":"10.2196/68967","DOIUrl":"10.2196/68967","url":null,"abstract":"<p><strong>Background: </strong>An accurate tongue strength and endurance assessment is necessary for pediatric dysphagia. TongueFit is a new portable orofacial manometer for measuring tongue strength and endurance and a game-based training app for children.</p><p><strong>Objective: </strong>This study tests the validity of TongueFit compared to the standard manometer as the current gold standard for measuring air pressure.</p><p><strong>Methods: </strong>This laboratory study compared TongueFit and a standard manometer as the gold standard for measuring air pressure. This study was conducted in 3 different experimental conditions. The first experiment compared TongueFit and the standard manometer using Force Tester (MCT-2150) and pressure controlled by MSatLite software. The second and third experiments involved 2 cm and 3 cm bulbs between the two devices. This study used Lin's concordance correlation to measure the level of agreement.</p><p><strong>Results: </strong>There was a mean absolute difference of 0.005 kPa between the TongueFit and the standard manometer (n=35, ρC=1.00). Statistical analysis shows perfect agreement correlation (ρC =1.000). By using the 2 cm bulb, TongueFit's mean is 0.007 kPa lower, also showing perfect agreement (ρC = 1.000). Moreover, using the 3 cm bulb, results show almost perfect agreement (ρC =0.999) with the TongueFit's mean 0.044 kPa lower.</p><p><strong>Conclusions: </strong>This study confirms the high validity of TongueFit as an orofacial manometer compared to the standard manometer, with negligible mean differences, near perfect and perfect agreement in the experiments. These results confirm that TongueFit is a valid and accurate tool for assessing tongue strength.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051491","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":"Home-Based Nonimmersive Virtual Reality Training After Discharge From Inpatient or Outpatient Stroke Rehabilitation: Parallel Feasibility Randomized Controlled Trial.","authors":"Lisa Sheehy, Anne Taillon-Hobson, Heidi Sveistrup, Martin Bilodeau, Christine Yang, Vivian Welch, Hillel Finestone","doi":"10.2196/64729","DOIUrl":"10.2196/64729","url":null,"abstract":"<p><strong>Background: </strong>Nonimmersive virtual reality training (NIVRT) can be used to continue rehabilitative exercise for stroke recovery at home after discharge from inpatient or outpatient therapy.</p><p><strong>Objective: </strong>The objectives of this randomized controlled feasibility trial were to assess home-based NIVRT as telerehabilitation with patients living with stroke, and its potential to improve standing function and gait.</p><p><strong>Methods: </strong>Patients approaching discharge from inpatient or outpatient stroke rehabilitation were randomly allocated to NIVRT or iPad interventions. NIVRT provided interactive games and exercises designed to improve balance, stepping, and aerobic capacity. iPad apps addressed cognition and fine motor skills. Participants were visited in their homes by a physiotherapist, taught to use the program, and asked to do 30 minutes of exercise 5 days a week for 6 weeks, asynchronously. Feasibility was assessed by measuring recruitment, adherence, ability to set up and learn NIVRT, enjoyment, intent to continue, perception of impact, and safety. Participants completed assessments of standing balance, gait, and general function, before and after the intervention, by a blinded assessor.</p><p><strong>Results: </strong>NIVRT participants (n=11; 10 male participants; mean age 64, SD 12 years) did an average of 26 sessions (total 700 minutes), while iPad participants (n=9; 6 male participants; mean age 61, SD 20 years) did an average of 33 sessions (total 1241 minutes). Space was tight in 5 homes. All but 1 participant learned NIVRT and progressed. Most enjoyed it and felt that it improved their recovery. There were no serious adverse events. Most assessments showed improvement over time for both groups.</p><p><strong>Conclusions: </strong>Home-based NIVRT is safe and feasible to continue rehabilitative exercise after discharge. More research on efficacy and effectiveness in this population is required.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03261713; https://clinicaltrials.gov/study/NCT03261713.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s13063-019-3438-9.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e64729"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736131","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":"Effects of a Home-Based Rehabilitation Exercise Program on Cardiorespiratory Performance in Community-Dwelling Adults Who Underwent Heart Surgery: Randomized Controlled Trial.","authors":"Natsinee Sermsinsaithong, Kornanong Yuenyongchaiwat, Chusak Thanawattano, Chatchai Buekban, Chitima Kulchanarat, Sasipa Buranapuntalug, Khanistha Wattanananont, Opas Satdhabudha","doi":"10.2196/68504","DOIUrl":"10.2196/68504","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing heart surgery demonstrate impaired cardiorespiratory performance. Phase II cardiac rehabilitation (CR) in people undergoing open heart surgery (OHS) aims to reduce the adverse physical effects of cardiovascular diseases. Virtual reality (VR) exercise is now used in CR.</p><p><strong>Objective: </strong>This study aimed to explore the effects of VR exercise on functional capacity, pulmonary function, and respiratory muscle strength in patients who underwent OHS and were in phase II CR.</p><p><strong>Methods: </strong>Forty-nine patients who underwent elective OHS and were in phase II CR were randomized into a VR group (N=24) and a control group (N=25). The VR group completed 8 weeks of a home-based VR exercise program, including chest trunk mobilization and aerobic circuit training for 30 minutes, whereas the control group received an exercise brochure and information regarding the benefits of exercise. Intention-to-treat analysis was conducted, and 2-way mixed ANOVA was performed to compare between- and within-group differences in functional capacity and respiratory performance.</p><p><strong>Results: </strong>After completing the 8-week program, the VR group showed significant improvement in functional capacity compared to the control group (66.29, SD 25.84 m; P=.01). Inspiratory muscle strength increased in both the VR and control groups compared to baseline (9.46, SD 2.85 and 9.64, SD 2.78 cm H2O, respectively). In addition, after the 8-week intervention, significant improvements were found in expiratory muscle strength (15.79, SD 4.65 cm H2O) and forced expiratory volume in 1 second as a percentage of predicted values (2.96%, SD 1.52%) in the VR group compared to the baseline session.</p><p><strong>Conclusions: </strong>The home-based VR exercise program significantly improved functional capacity but not respiratory muscle or pulmonary function.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68504"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754972","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 Technology System to Help People With Multiple Disabilities Increase Contact With Objects and Control Environmental Stimulation: Single-Case Research Design.","authors":"Giulio E Lancioni, Gloria Alberti, Chiara Filippini, Nirbhay N Singh, Mark F O'Reilly, Jeff Sigafoos, Valeria Chiariello, Oriana Troccoli","doi":"10.2196/70378","DOIUrl":"10.2196/70378","url":null,"abstract":"<p><strong>Background: </strong>People with severe-to-profound intellectual disability and sensory-motor impairment tend to be passive and detached from their immediate context.</p><p><strong>Objective: </strong>This study assessed a new technology system using a webcam to detect participants' responses (ie, hand contact with objects) and to trigger computer delivery of preferred environmental stimulation, such as music, contingent on (immediately after) the occurrence of those responses.</p><p><strong>Methods: </strong>In total, 8 adults with severe to profound intellectual disability and extensive motor and visual impairments participated in the study. Each participant was exposed to an ABACB design. The technology system did not provide stimulation during the A (baseline) phases, provided stimulation contingent on the responses during the B (intervention) phases, and provided stimulation throughout the sessions during the C (control) phase. Sessions lasted 5 minutes.</p><p><strong>Results: </strong>During the first baseline phase, the participants' mean frequency of responses per session was between about 3 and 6.5. During the first intervention phase, it increased to between about 10 and 18. It showed a clear decline during the second baseline phase, remained low during the control phase, and increased again during the second intervention phase. During this phase, it ranged from about 13 to 19.5.</p><p><strong>Conclusions: </strong>The new technology system might be a useful tool to help people with intellectual and sensory-motor disabilities increase object contact and stimulation control.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70378"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674458","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}