JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Internet-Based Telerehabilitation Versus in-Person Therapeutic Exercises in Young Adult Females With Chronic Neck Pain and Forward Head Posture: Randomized Controlled Trial.","authors":"Patcharin Nilmart, Arrada Sichuai, Asree Chedang, Chanikarn Goontharo, Nollapan Janjamsai","doi":"10.2196/74979","DOIUrl":"10.2196/74979","url":null,"abstract":"<p><strong>Background: </strong>Neck pain is a common musculoskeletal disorder, often linked to forward head posture (FHP). Studies have shown that exercise interventions can improve pain, craniovertebral angle (CVA), range of motion, and function in individuals with FHP. While telerehabilitation exercise has proven effective for other musculoskeletal conditions, its effectiveness in addressing neck pain and FHP is still being investigated.</p><p><strong>Objective: </strong>This study aimed to evaluate and compare the effectiveness of an internet-based telerehabilitation therapeutic exercise program with an in-person supervised program in improving clinical outcomes among young adult females with chronic nonspecific neck pain and FHP. The study hypothesized that there would be no significant differences in outcomes between the 2 groups.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted with 50 participants experiencing chronic neck pain and FHP, recruited through public announcement and voluntary sign-up. Participants were randomly assigned to either a telerehabilitation group or an in-person supervision group. Both groups completed the same 6-week, physiotherapist-supervised therapeutic exercise program, delivered via Zoom (Zoom Video Communications) or in the physiotherapy department laboratory, respectively. Outcome assessments were conducted face-to-face by blinded assessors at baseline, after 4 and 6 weeks of intervention, and at a 2-week follow-up. Outcome measures included pain intensity (assessed using the Visual Analog Scale [VAS]), CVA, neck disability (assessed using the Neck Disability Index [NDI]), and cervical range of motion (CROM). Adherence was monitored using attendance logs.</p><p><strong>Results: </strong>Of the 50 participants, 48 completed the intervention with 1 dropout from each group. Adherence among completers was 100 percent in both groups. All 50 participants were included in the analysis using the intention-to-treat principle. No differences in effectiveness were found between the telerehabilitation and in-person groups, as no significant interaction effect between group and time was observed across all outcome measures including VAS, CVA, NDI, and CROM (P values ranged .07-.61). However, improvements were observed in all outcomes across time, including a 2.2- to 4.1-cm reduction in VAS, 5°-8.8° increase in CVA, 3.3- to 7.1-point reduction in NDI (P<.001 for all), and 3.5°-22.7° increase in CROM (P<.001 to P=.04).</p><p><strong>Conclusions: </strong>Both telerehabilitation and in-person supervision were similarly effective in improving pain, posture, neck disability, and CROM in young adult females with chronic neck pain and FHP. These findings suggest that telerehabilitation may be a feasible and accessible alternative to conventional in-person therapeutic exercise programs for managing chronic neck pain with FHP.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e74979"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715204","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":"Grab Bar Grasp Location During Bathtub Exit and Sit-to-Stand Transfers: Biomechanical Evaluation.","authors":"Iris C Levine, Konika Nirmalanathan, Roger E Montgomery, Alison C Novak","doi":"10.2196/69442","DOIUrl":"10.2196/69442","url":null,"abstract":"<p><strong>Background: </strong>Grab bars are a multi-function bathing tool. While grab bars are commonly recommended by rehabilitation professionals, existing literature regarding optimal grab bar locations is focused on preference rather than function.</p><p><strong>Objective: </strong>This study aimed to evaluate grab bar grasp location on 8 grab bar configurations during bathtub exit, with and without balance loss, and sit-to-stand (STS) from a bath seat.</p><p><strong>Methods: </strong>Motion capture was used to evaluate grasp location during bathing activities in 28 older (65+ years) and 37 younger (18-35 years) adults. Grasp location was compared between age groups and balance loss conditions using ANOVA, and correlated with body height.</p><p><strong>Results: </strong>Vertical grasp location varied from close to the bathtub rim to more than 1 meter above the bathtub rim (maximum 22.4 cm), while horizontal grasp location was close to the bathtub rim during bathtub exit, and close to the bath seat during STS. Young adult participants grasped 9.4% lower on vertical grab bars during perturbation trials than nonperturbation trials (P<.01). Body height was positively correlated with grasp height on a vertical grab bar during nonperturbation trials (r=0.67, P<.01), and negatively correlated with grasp distance on a low horizontal grab bar during STS (r=-0.37, P=.03).</p><p><strong>Conclusions: </strong>Grab bar grasp location varied between proactive and reactive grasp scenarios and was linked to user height for some situations. These findings may be used to guide the selection of a grab bar installation location to support multiple bathing tasks.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69442"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691852","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 the Perceptions of Voice-Assisted Technology as a Tool for Speech and Voice Difficulties: Focus Group Study Among People With Parkinson Disease and Their Carers.","authors":"Jodie Mills, Orla Duffy, Katy Pedlow, George Kernohan","doi":"10.2196/75316","DOIUrl":"10.2196/75316","url":null,"abstract":"<p><strong>Background: </strong>People with Parkinson disease (PD) often report low volume and reduced intelligibility of speech. Common household devices that use voice-assisted technology (VAT) require users to speak slowly, clearly, and loudly for the technology to function. For people with PD, this can be challenging, but this also suggests that VAT may have potential as a therapeutic tool. While VAT is an emerging health care technology, it is important to better understand the thoughts and experiences of people with PD who are already using it despite having speech and voice difficulties.</p><p><strong>Objective: </strong>This study aimed to explore experiences of using VAT to address hypokinetic dysarthria secondary to PD, based on the perspectives of people with PD and family carers.</p><p><strong>Methods: </strong>People with PD experiencing mild to moderate speech changes who were smart speaker users, and their carers, were invited to participate in 1 of 4 in-person focus groups. Between September and December 2024, focus groups were audiovisually recorded. A semistructured topic guide informed by published evidence was used to guide discussions. Results were transcribed and analyzed through a framework analysis approach (managed using NVivo software).</p><p><strong>Results: </strong>A total of 15 participants, including 8 (53%) people with PD and 7 (47%) carers, participated in 4 in-person focus groups. Findings revealed shared experiences with VAT that were marked by its therapeutic potential and practical challenges. Five main themes were identified: (1) therapeutic potential for speech and voice, with subthemes of changes in volume, intelligibility, and clarity of speech; the role of VAT feedback; and VAT as an everyday device; (2) distrust of technology, with concerns surrounding data privacy, the listening nature of devices, and measures users take to protect themselves; (3) frustrations with devices, including devices not understanding, devices timing out, and the lack of conversation; (4) support needs, including the impact of a lack of knowledge and the need for education and guidance; and (5) design considerations for a future VAT tool in speech and language therapy (SLT).</p><p><strong>Conclusions: </strong>This study extends on previous research findings, demonstrating that VAT may be acceptable to people with PD to create changes in volume, clarity, and intelligibility. However, attention must be given to users' privacy concerns and frustrations with devices before VAT can used as a tool in SLT. Future research should design solutions to address current usability challenges with people with PD and professionals in three ways: (1) co-designing education and guidelines for people with PD, describing the use of VAT for speech and voice difficulties; (2) refining commercial VAT for use in SLT; and (3) establishing the feasibility of a therapeutic VAT intervention for people with PD with speech and voice difficulties.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e75316"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650801","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":"Improved Speech Recognition in Adults With Conductive or Mixed Hearing Loss Using a Direct-to-Consumer Bone-Conduction Device: A Multiple Methods Intervention Study.","authors":"Thomas Hampton, Mark Fletcher, Alan Sanderson, Manuel Loureiro, Kevin Mortimer, Mahmood F Bhutta","doi":"10.2196/66013","DOIUrl":"10.2196/66013","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss affects 20% of the global population, including 250 million experiencing chronic suppurative otitis media, which can present challenges for conventional hearing aids due to ear discharge. Although assistive technology for hearing is available in high-income settings, provision is poor in low-income settings due to high costs and low availability of audiology services, reaching approximately 3% of those who could benefit from it.</p><p><strong>Objective: </strong>This study aimed to evaluate the performance of a low-cost self-fitted direct-to-consumer bone-conduction headset for individuals with conductive or mixed hearing loss.</p><p><strong>Methods: </strong>We conducted a multiple methods study to test the efficacy and acceptability of this device using a purposive sample. Participants with a range of conductive and mixed hearing loss underwent speech-in-quiet speech audiometry with and without the device and took part in feedback interviews exploring their subjective impressions of the device.</p><p><strong>Results: </strong>In 33 participants, the device improved speech recognition in those with bone conduction thresholds <50 dB by a median of 11%, with larger air-bone gap associated with larger improvement. Participants rated the device positively on weight, style, and ease of use.</p><p><strong>Conclusions: </strong>This multiple methods study assessed the acceptability and efficacy of a low cost self-fitted bone-conduction device in adults. We found the device provides hearing benefit for those with conductive or mixed hearing loss (with bone conduction thresholds <50dB HL). Those with significant conductive hearing loss were measured to have their speech perception significantly improved. Participants had a mixed response to device aesthetics. Further studies should seek to establish if this type of device has effectiveness in real-world trials and which individuals are most likely to benefit. This low cost device could provide hearing benefits to millions of people without access to other devices. Product designers and clinical researchers should explore device optimization. Given the economic impacts of hearing loss across the globe, this style of self-fitted device could represent a paradigm shift in future assistive technology for hearing loss, in both high and low resource settings.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66013"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643705","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 Safety of Telerehabilitation: Systematic Review.","authors":"Hila Shnitzer, Josh Chan, Thomas Yau, McKyla McIntyre, Angie Andreoli, Ailene Kua, Mark Bayley, Carl Froilan Leochico, Meiqi Guo, Sarah Munce","doi":"10.2196/68681","DOIUrl":"10.2196/68681","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Telerehabilitation involves the delivery of rehabilitation services over a distance through communication technologies. In contrast to traditional in-person rehabilitation, telerehabilitation can help overcome barriers including geographic distance and facility use. There is evidence to suggest that telerehabilitation can lead to increased patient engagement and adherence to treatment plans. However, limited research exists on the association of telerehabilitation with adverse events, potentially hindering its broader adoption and use in health care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This systematic review of randomized controlled trials aims to summarize existing research on adverse events related to telerehabilitation delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review was conducted according to the methodological framework outlined by the Joanna Briggs Institute. Studies were identified from MEDLINE ALL, Embase, APA PsycINFO, CENTRAL, and CINAHL. Included studies were randomized controlled trials published between 2013 and 2023, written in English, and had no geographic or delivery mode restrictions. Data extraction used the TIDieR (Template for Intervention Description and Replication) framework, along with authors, publication year, sample size, specific telerehabilitation modes, and the incidence, type, severity, and relatedness of reported adverse events. Methodological quality was assessed using the Cochrane risk of bias tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Search results identified 9022 references, of which 37 randomized controlled trials met the criteria for inclusion. There were a total of 3166 participants, with a mean age of 57.4 (SD 11.3) years, and 1023 (32.3%) being female participants. Various delivery modes were used, with videoconferencing emerging as the most frequently used method. A total of 201 adverse events were recorded during 65,352 sessions (0.31% or 3.1 per 1000 sessions). These events were predominantly physical (eg, falls and palpitations), nonserious or mild, and not directly attributed to the telerehabilitation intervention. Additionally, 34 (92%) of included studies implemented various safety practices including vital sign monitoring, safety checklists, and scheduled check-ins with study personnel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This review demonstrates that telerehabilitation exhibits a generally safe profile as an alternative to in-person rehabilitation, with most reported adverse events being rare, nonserious or mild, and unrelated to telerehabilitation protocols. However, more extensive research with detailed reporting on adverse event characteristics is needed. Moreover, future research should evaluate the effectiveness of different safety practices and their association with adverse events. An enhanced understanding of potential risks in tele","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68681"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601785","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 Rehabilitation Patients' Perspectives on What Matters for the Adoption of Home-Based Rehabilitation Technology: Q-Methodology Study.","authors":"Karlijn E Te Boekhorst, Sanne J Kuipers, Gerard M Ribbers, Jane M Cramm","doi":"10.2196/71515","DOIUrl":"10.2196/71515","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation technologies can support recovery and rehabilitation outside clinical settings. However, their adoption remains challenging. Factors such as ease of use, perceived benefits, and social influence play a role, but little is known about how rehabilitation patients perceive their relative importance.</p><p><strong>Objective: </strong>This study aimed to systematically explore the viewpoints of rehabilitation patients regarding the adoption of home-based rehabilitation technology.</p><p><strong>Methods: </strong>Between May and September 2024, this study examined the viewpoints of rehabilitation patients with acquired brain injury regarding the adoption of home-based rehabilitation technology using Q-methodology. A purposive sample of 21 participants ranked 34 opinion statements based on perceived importance and explained their choices during follow-up interviews. By-person factor analysis identified common patterns in how participants ranked the statements. These patterns, referred to as factors or viewpoints, were further interpreted using qualitative interview data.</p><p><strong>Results: </strong>Three viewpoints were identified, each highlighting different factors important for adopting home-based rehabilitation technology: (1) technology supporting rapid recovery, (2) technology supporting independence and self-control, and (3) technology as a supporting partner. Participants consistently emphasized the importance of regaining independence, receiving feedback during exercises, simple and easy-to-use designs, and approval from therapists, while positive reports in mainstream media, support from friends, and reducing travel to rehabilitation centers were considered less important.</p><p><strong>Conclusions: </strong>The findings suggest that rehabilitation patients with acquired brain injury prioritize different factors when adopting home-based rehabilitation technology. While some factors are commonly valued, the diversity in patient viewpoints underscores the need for tailored, user-centered approaches in the design and implementation of these technologies. A one-size-fits-all approach would likely be ineffective in meeting their varying needs.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e71515"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Challenges in Implementing a Digital Play Intervention in a Complex Organization Across Pediatric Departments: Non-Randomized Controlled Feasibility Trial.","authors":"Laerke Winther, Michelle Stahlhut, Derek John Curtis, Christian Have Dall, Thomas Leth Frandsen, Jette Led Sorensen","doi":"10.2196/58019","DOIUrl":"10.2196/58019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients and health care providers can use playful digital games in a hospital setting to increase motivation and distract patients during painful procedures. Future digital interventions for pediatric hospitalization must do more than distract; they must also encourage socialization and promote physical activity, for example, by exploring novel interactive approaches to boost motivation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The pilot study investigated the feasibility of a non-randomized controlled trial (non-RCT) assessing a new digital play intervention, Monster Gardener, that aims to motivate and increase physical activity for children and adolescents in a hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This feasibility study was a non-RCT conducted from October to December 2023. We recruited hospitalized children, 7-17 years of age, and health care professionals from 4 pediatric departments at Copenhagen University Hospital - Rigshospitalet, Denmark. The children were allocated to intervention and control groups. Data collection included physical activity data measured with accelerometers, data on app use, and usability questionnaires completed by participants and health care professionals. The control group received usual care and accelerometer measurements, while the intervention group received accelerometer measurements and was invited to play Monster Gardener. We applied the 8 focus areas by Bowen et al to describe and evaluate the app's feasibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 22 children and adolescents from 3 pediatric departments agreed to participate. Our main findings, based on the framework by Bowen et al, were (1) acceptability: prolonged recruitment due to fewer hospital stays more than 24 hours than expected; (2) demand: software coding error in the app prevented data registration, causing a potentially major risk of data loss; (3) practicality: Monster Gardener was incompatible with certain mobile phones, and discomfort from the adhesive plasters used to attach the accelerometer led to early removal by one-third of participants; (4) implementation: technical problems and perceived complexity hindered successful app deployment; (5) adaptation: the app demonstrated adaptability across different departments; (6) integration: enhanced information sessions with the health care professionals were needed prior to data collection, and participants were too exhausted and overwhelmed by consultations, blood tests, examinations, and pain and nausea from surgical procedures to use the app; (7) expansion: app facilitation requires additional resources, posing a challenge given limited availability of staff; and (8) limited-efficacy testing: participants were inactive 22 hours a day and data loss limited efficacy testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The digital play intervention showed that Monster Gardener could potentially motivate children to be physically active during pediatric hospitalizat","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e58019"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592502","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":"Human Guide Training to Improve Hospital Accessibility for Patients Who Are Blind: Needs Assessment and Pilot Process Evaluation.","authors":"Tyler G James, Sarah Hughes, Christa Moran, Sherry Day, Michael M McKee","doi":"10.2196/64666","DOIUrl":"10.2196/64666","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities are a priority population for health services research. People who are blind or have low vision (B/LV) are a segment of this priority population, who experience difficulty in accessing health care facilities due to architectural and navigational barriers. These barriers persist despite disability civil rights law in the United States.</p><p><strong>Objective: </strong>The purpose of this study is to report on a program that was developed to train way finders in human guide technique for people who are B/LV.</p><p><strong>Methods: </strong>This study took place at Michigan Medicine, an academic medical center in southeast Michigan. We conducted a needs assessment through cohort discovery and soliciting expert feedback. The human guide training program was developed using the PRECEDE-PROCEED health promotion program development model and targeted health care volunteers and staff. The intended components included in-person training, a web-based module, and tip sheets. Due to COVID-19, the in-person training was not implemented. We report findings from a process evaluation, measuring reach, knowledge, behavioral capability, and satisfaction pre- and postprogram.</p><p><strong>Results: </strong>In total, 87 participants completed the training, and most of them were Michigan Medicine volunteers. There were significant improvements in behavioral capability related to the human guide technique. Participants were satisfied with the training and provided recommendations for more detailed demonstrations and scenarios in future training sessions.</p><p><strong>Conclusions: </strong>The training improves participants' knowledge and confidence in providing wayfinding assistance to patients who are B/LV. However, further in-person training is recommended to provide hands-on experience and detailed feedback. Addressing architectural barriers and providing accessible patient education materials is crucial for improving health care accessibility for patients who are B/LV.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e64666"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561409","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":"Lessons Learned From the Integration of Ambient Assisted Living Technologies in Older Adults' Care: Longitudinal Mixed Methods Study.","authors":"Oteng Ntsweng, Martin Kodyš, Zhi Quan Ong, Fang Zhou, Antoine de Marassé-Enouf, Ibrahim Sadek, Hamdi Aloulou, Sharon Swee-Lin Tan, Mounir Mokhtari","doi":"10.2196/57989","DOIUrl":"10.2196/57989","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has given impetus to an already growing trend around the use of ambient assisted living (AAL) technologies to support frail older adults who live alone. However, the challenge is that systematic research on the long-term use of AAL technologies remains in its nascent stages, leaving gaps in the understanding of the predictors that contribute to the routine embedding of AAL technologies in older adults' care.</p><p><strong>Objective: </strong>This paper aims to share key lessons from a longitudinal study on the routine embedding of AAL technologies in older adults' care within a hitherto under-studied Southeast Asian context. Our objective was to design and deploy an AAL 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. To assess changes in QOL, we administered a simplified, gamified version of the validated Older People's Quality of Life Questionnaire. Finally, we conducted semistructured 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 (P=.01) and (2) leisure and social activities (P=.03) 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 older adults felt more cared for, while others perceived a decline in in-person visits. This paradox highlighted the complexities of technology's role in caregiving, as it might simultaneously enhance feelings of safety while unintentionally diminishing social connection for some older adults.</p><p><strong>Conclusions: </strong>AAL technologies such as Ubismart enhance older adults' psychological and emotional well-being and sense of safety but may inadvertently reduce social interaction. Sustainable integration requires balancing these benefits with efforts to maintain meaningful caregiver connections, supporting both safety and social engagement for older adults.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06486935; https://clinicaltrials.gov/study/NCT06486935.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e57989"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081182","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":"Wearable-Enhanced mHealth Intervention to Promote Physical Activity in Manual Wheelchair Users: Single-Group Pre-Post Feasibility Study.","authors":"Zijian Huang, Dan McCoy, Rosemarie Cooper, Theresa M Crytzer, Yueyang Chi, Dan Ding","doi":"10.2196/70063","DOIUrl":"10.2196/70063","url":null,"abstract":"<p><strong>Background: </strong>With the rapid advancement of technology, using wearable devices and mobile health (mHealth) apps to monitor and promote physical activity (PA) has become increasingly popular among individuals with various chronic conditions. However, such work remains limited among individuals with spinal cord injury (SCI), especially those who use a manual wheelchair for mobility.</p><p><strong>Objectives: </strong>The study aims to describe the development of the WheelFit mHealth app for monitoring and promoting PA in manual wheelchair users (MWUs) with SCI and evaluate its feasibility and usability in free-living conditions.</p><p><strong>Methods: </strong>The WheelFit app, based on the Fogg Behavioral Model with inputs from stakeholders, including MWUs, physical therapists, and personal trainers, was developed to promote PA in MWUs. It works with two commercial wearable devices, that is, an Android smartwatch and a wheel sensor, which stream users' upper extremity and wheelchair movement to the app to calculate PA variables using custom algorithms. Users can set personal goals, review daily progress and PA history, and access an adaptive workout library within the app. A 4-week single-group pre-post study, consisting of a 1-week baseline and 3-week intervention phase, was conducted to evaluate WheelFit's feasibility and usability. Feasibility was evaluated using the session attendance rate, device and app usage, and implementation of action plans. Usability was assessed using the system usability scale. The preliminary effectiveness was assessed by comparing preintervention and postintervention PA variables and scores from the SCI exercise self-efficacy scale.</p><p><strong>Results: </strong>A total of 16 participants completed the study protocol with 100% session attendance and maintained 14.2 hours of daily device and app connection. Participants demonstrated varying levels of adherence to their action plans. The excellent usability of WheelFit was indicated by an average system usability scale score of 81.8 (SD 19.2) points. Statistically significant increases between pre-post daily exercise times (preintervention: mean 26.4, SD 16.9 minutes; postintervention: mean 33.3, SD 24.9 minutes; P=.049) and exercise self-efficacy scale scores (preintervention: mean 33.9, SD 4.5 points; postintervention: mean 35.9, SD 3.2 points; P=.043) were observed.</p><p><strong>Conclusions: </strong>The WheelFit app demonstrated promising feasibility, usability, and a positive impact on promoting PA in MWUs with SCI. Future investigation exploring the potential integration of the WheelFit app into clinical practice is warranted.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70063"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235446","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}