JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Addendum: Managing Musculoskeletal Pain in Older Adults Through a Digital Care Solution: Secondary Analysis of a Prospective Clinical Study.","authors":"Anabela C Areias, Dora Janela, Maria Molinos, Robert G Moulder, Virgílio Bento, Vijay Yanamadala, Steven P Cohen, Fernando Dias Correia, Fabíola Costa","doi":"10.2196/97495","DOIUrl":"10.2196/97495","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2196/49673.].</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e97495"},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841595","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":"Digital Aids for Social Media in Adults With Traumatic Brain Injury: Longitudinal Evaluation Study.","authors":"Dakota Sullivan, Nirav N Patel, Lisa Kakonge, Callie Y Kim, Yaxin Hu, Hailey L Johnson, Catalina L Toma, Melissa Duff, Lyn Turkstra, Bilge Mutlu","doi":"10.2196/83639","DOIUrl":"10.2196/83639","url":null,"abstract":"<p><strong>Background: </strong>Digital social media aids are features that enhance accessibility to social media for users with disabilities. One group of adults with disabilities who have reported barriers to social media access is adults with traumatic brain injury (TBI). Results of previous studies showed that adults with TBI want to engage in social media but encounter significant barriers to doing so, due in large part to TBI-related cognitive and communication challenges. We previously collaborated with adults with TBI to develop 5 aids to increase social media access. Aids were implemented as Chrome extensions that modified user interface functions and visuals on Facebook. The present study was the next step: testing the use of the 5 aids by a novel group of adults with TBI longitudinally and in naturalistic settings.</p><p><strong>Objective: </strong>This study aimed to determine (1) how participants perceived each aid (ie, in terms of satisfaction, usability, likes, and dislikes), (2) how aids influenced participants' well-being, and (3) which aid features participants rated as most and least useful.</p><p><strong>Methods: </strong>We recruited 39 adult Facebook users with TBI to take part in an approximately 1-month-long within-subject evaluation study of Facebook browser aids. Each aid was used for 3 days, followed by an evaluation and a subsequent 2-day no-aid use period. Participants evaluated each of the 5 unique browser aids in a randomized order.</p><p><strong>Results: </strong>Users reported the aids to be beneficial, especially aids that reduced visual clutter and information overload. Users also reported increased life satisfaction after using the aids (P=.02).</p><p><strong>Conclusions: </strong>These results provide proof of concept for the types of digital aids that could improve access to social media for users with TBI. We advocate including aids like these across all social media platforms so users with TBI can access the benefits of engagement in social media with fewer barriers.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e83639"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833157","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 Using a Lumbar-Type Hybrid Assistive Limb by Older Adults With Frailty on Exercise Self-Efficacy: Retrospective Analysis Based on the Kanagawa Prospective ME-BYO Cohort Study.","authors":"Makoto Nagasawa, Sho Nakamura, Yoshinobu Saito, Yuko Oguma, Takashi Kasukawa, Kaname Watanabe, Hiroto Narimatsu","doi":"10.2196/79358","DOIUrl":"10.2196/79358","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Improving exercise self-efficacy (ESE) is a key strategy for promoting sustained physical activity among older adults with frailty. The lumbar-type Hybrid Assistive Limb (HAL), a wearable device that supports voluntary movement through bioelectric signals, may facilitate mastery experiences in individuals with low baseline self-efficacy via adjustable assistance. However, its effects on ESE remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the effects of lumbar-type HAL exercise on ESE in older adults with frailty and examined whether responsiveness differed according to baseline readiness for exercise.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective pooled analysis was conducted using data from 2 prospective studies of a lumbar-type HAL-based frailty prevention program: a feasibility study (n=20) and a randomized controlled trial (RCT; n=76; lumbar-type HAL group: n=38; waitlist control: n=38). Participants aged 50 to 84 years performed sit-to-stand and squat exercises using the lumbar-type HAL twice weekly. ESE was assessed using a validated 4-item questionnaire (range 4-20). The prespecified primary analysis examined within-person changes in ESE in the lumbar-type HAL group (2-tailed paired &lt;i&gt;t&lt;/i&gt; test; n=96). A secondary analysis compared changes in ESE between the lumbar-type HAL and waitlist control groups in the RCT using the Welch &lt;i&gt;t&lt;/i&gt; test and baseline-adjusted analysis of covariance. A prespecified subgroup analysis compared participants in stages 1 to 4 of the transtheoretical model of behavior change (exercise habit not established) with those in stage 5 (maintenance). All statistical tests were 2 sided, with significance at &lt;i&gt;P&lt;/i&gt;&lt;.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The primary pooled paired analysis demonstrated a significant increase in ESE of 1.05 points (95% CI 0.41-1.69; &lt;i&gt;P&lt;/i&gt;=.002). The subgroup analysis was also significant: those in stages 1 to 4 (n=56) improved by 1.73 points vs 0.05 points for those in stage 5 (n=38), a difference of 1.68 points (95% CI 0.41-2.95; &lt;i&gt;P&lt;/i&gt;=.01). The largest within-group improvement was observed in stage 1 (precontemplation: +3.50 points, 95% CI 0.27-6.73; &lt;i&gt;P&lt;/i&gt;=.04; Cohen &lt;i&gt;d&lt;/i&gt;=1.14); 4 of 6 participants improved and none deteriorated. In the secondary RCT between-group comparison, the lumbar-type HAL group showed a directionally favorable improvement (between-group difference=1.21 points, 95% CI -0.33 to 2.75; &lt;i&gt;P&lt;/i&gt;=.12; Cohen &lt;i&gt;d&lt;/i&gt;=0.36). The subgroup differences were 2.10 points in stages 1 to 4 (&lt;i&gt;P&lt;/i&gt;=.07; Cohen &lt;i&gt;d&lt;/i&gt;=0.58) and 0.02 points in stage 5 (&lt;i&gt;P&lt;/i&gt;=.99). Sensitivity analyses confirmed robustness to source-related heterogeneity (heterogeneity test: &lt;i&gt;P&lt;/i&gt;=.74; source-adjusted regression: &lt;i&gt;P&lt;/i&gt;=.76).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The pooled analysis demonstrated significant within-person improvement in ESE among older adults with frailty following lumbar-type HAL training, with the gr","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e79358"},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814449","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":"Goal Setting During Telerehabilitation in Japan: Qualitative Study of Occupational Therapists' and Physical Therapists' Experiences Using Reflexive Thematic Analysis.","authors":"Yuho Okita, Kounosuke Tomori, Minoru Okita","doi":"10.2196/101355","DOIUrl":"https://doi.org/10.2196/101355","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Telerehabilitation expanded rapidly during the COVID-19 pandemic and is increasingly used alongside, or as an alternative to, in-person rehabilitation. Goal setting is a core component of client-centered rehabilitation; however, how therapists conduct goal setting remotely remains poorly understood, particularly in East Asian contexts. To our knowledge, no qualitative study has specifically examined remote goal setting in telerehabilitation in Japan, where remote delivery was not yet routine when these data were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This qualitative study aimed to explore how Japanese occupational therapists and physical therapists experienced negotiating and adapting rehabilitation goals during telerehabilitation, including how remote delivery shaped assessment, collaboration, and the purposes assigned to goals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Individual semistructured interviews (18-51 minutes; mean 32 minutes) were conducted via Zoom (Zoom Communications, Inc) in Japanese with 9 therapists (7 occupational therapists and 2 physical therapists; 7 male and 2 female; aged 29-43 years) who had direct experience of remote goal setting. Participants were recruited by purposive and snowball sampling from 9 different workplaces across Japan, including metropolitan areas such as Tokyo and regional areas such as Hokkaido and Nagasaki, and worked in hospital, private-practice, community-based, and academic settings. Data were analyzed using reflexive thematic analysis within a contextualist epistemology, following Braun and Clarke. Trustworthiness was considered using Nowell and colleagues' criteria, and reporting followed the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four themes were constructed: (1) losing touch: uncertainty in remote assessment and goal setting (9/9 participants); (2) from direct intervention to coaching-oriented goal setting (8/9 participants); (3) at home, at ease: needs that surface in clients' own environments (6/9 participants); and (4) when continuity becomes the goal (6/9 participants). Therapists described remote goal setting as shaped by both constraint and possibility. Partial bodily, nonverbal, and contextual information reduced their confidence in assessment and goal negotiation, and they responded through preparation, visual resources, self-monitoring tools, and collaboration with clients and families. Sessions conducted in clients' own environments appeared to support comfort and sometimes made everyday needs more visible. When in-person care was unavailable or insufficient, therapists sometimes broadened goals from functional improvement alone to include continuity, ongoing monitoring, and prevention of disengagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In these therapists' accounts, remote goal setting was not simply a diminished version of in-person practice but a distinct clinical process requiring","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e101355"},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798999","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":"Deep Learning-Based Automated Clinical Gait Assessment From Kinematic Data in People With Stroke: Development and Validation Study.","authors":"Zhexuan Gu, Jiaqi Li, Wenbin Zhou, Kenneth N K Fong, Lin Wang, Eng Keong Lua, Patrick W H Kwong, Yancheng Yuan","doi":"10.2196/94031","DOIUrl":"https://doi.org/10.2196/94031","url":null,"abstract":"<p><strong>Background: </strong>Gait impairment is a prevalent sequela of stroke. Although observational gait analysis remains a standard clinical practice for assessing neuromotor impairments in people with stroke, it is prone to subjective bias. Consequently, objective assessment is required to inform effective rehabilitation protocols.</p><p><strong>Objective: </strong>This study aimed to validate a deep learning framework for automating clinical gait assessment using kinematic data.</p><p><strong>Methods: </strong>This study was conducted in a university-affiliated gait analysis laboratory. Kinematic data were collected from 51 individuals with hemiparetic stroke and 18 healthy controls using wearable inertial measurement units, and video recordings were obtained for the Wisconsin Gait Scale (WGS) scoring. WGS scores, rated by 2 experienced physiotherapists, were used to establish the expert reference standard. A statistical graph convolutional network (STAT-GCN), incorporating a STAT-Attention Head module, was developed to predict WGS items 2 to 14 from kinematic data. Model evaluation was performed using a stratified, participant-level 5-fold cross-validation protocol, with all gait cycles from the same participant kept within the same fold. Model performance was assessed at the participant level using exact accuracy, mean absolute error, and weighted κ metrics. A descriptive comparison involving 4 final-year physiotherapy students was also conducted.</p><p><strong>Results: </strong>Among participants with stroke, STAT-GCN achieved an overall exact accuracy of 75.42% for WGS items 2 to 14, with a mean absolute error of 0.290 score levels. Across the participant-level 5-fold cross-validation test sets, STAT-GCN achieved a mean exact accuracy of 75.64% (SD 6.58%), whereas the 4 student evaluators achieved mean accuracies ranging from 56.19% (SD 7.03%) to 67.09% (SD 4.03%).</p><p><strong>Conclusions: </strong>The proposed STAT-GCN framework demonstrated reasonable preliminary performance for automated WGS item prediction in individuals with stroke. The results suggest that kinematic data-driven models may support more standardized gait assessment, but performance should be interpreted cautiously given the limited sample size, class imbalance across WGS score items, and absence of external validation. Further studies with larger and more clinically diverse stroke cohorts are needed before clinical implementation.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e94031"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799024","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":"Impact of Emerging Technologies on Outpatient Care Quality: Mixed Methods Study.","authors":"Inas Al Khatib, Mahmoud Awad, Abdulrahim Shamayleh","doi":"10.2196/81847","DOIUrl":"https://doi.org/10.2196/81847","url":null,"abstract":"<p><strong>Background: </strong>Digital transformation in health care, including telemedicine, wearable devices, robotic process automation (RPA), and electronic medical records (EMRs), is reshaping outpatient care delivery. However, consolidated evidence on how these technologies influence patient care quality (PCQ) remains limited.</p><p><strong>Objective: </strong>This study evaluated the impact of emerging digital health technologies on PCQ dimensions in outpatient clinics through a systematic literature review combined with expert perspectives.</p><p><strong>Methods: </strong>A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines was conducted across ABI/INFORM, ScienceDirect, MEDLINE, and Google Scholar to identify studies published between 2017 and 2022. Studies examining digital technologies and their effects on outpatient PCQ were included. After screening and eligibility assessment, 53 studies were retained for synthesis. In parallel, semistructured interviews were conducted with 19 subject matter experts from public health, health informatics, and outpatient clinical practice. Findings were thematically analyzed using SERVQUAL (Service Quality Model) dimensions: responsiveness, reliability, empathy, communication, and tangibles, and triangulated across both datasets.</p><p><strong>Results: </strong>RPA led to substantial reductions in waiting times, while telemedicine improved accessibility and continuity of care, as highlighted by 14 of 19 experts. Wearable devices enhanced remote monitoring and patient engagement but required adequate digital literacy. Several studies (n=7) reported that EMR usability challenges negatively affected patient-physician communication. Overall, improvements were most evident in responsiveness and communication, while empathy and patient-centeredness remained comparatively weaker without targeted training and workflow adjustments.</p><p><strong>Conclusions: </strong>Emerging digital health technologies can enhance outpatient PCQ, particularly in operational efficiency, access to care, and communication. This review is innovative in that it integrates evidence across telemedicine, wearable monitoring, RPA, and EMRs within a unified SERVQUAL framework, offering practical guidance for implementing patient-centered digital health strategies in outpatient settings.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e81847"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798992","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":"Ecological Momentary Assessment of Daily Activities in Individuals With Neurological Disorders: Scoping Review.","authors":"Eva Delooz, Barbara Piškur, Aki Rintala, Bruno Bonnechère, Annemie Spooren","doi":"10.2196/92797","DOIUrl":"10.2196/92797","url":null,"abstract":"<p><strong>Background: </strong>Daily activities shape individuals' health and well-being, reflecting functioning and lived health. For people with neurological conditions, these activities are often disrupted, affecting autonomy and quality of life. Traditional assessments miss subtle, real-time fluctuations, whereas ecological momentary assessment (EMA) captures moment-to-moment activity within natural contexts, offering insight into person-environment-occupation interactions. Despite its growing use, it remains unclear how EMA protocols conceptualize daily activities and integrate person-environment-occupation dimensions in applications for neurological populations.</p><p><strong>Objective: </strong>This scoping review aims to map the existing literature on the use of EMA to capture daily activities, ranging from basic self-care to more complex activities, in individuals with neurological disorders.</p><p><strong>Methods: </strong>A scoping review was conducted to map studies using EMA to capture daily activities in adults with neurological conditions, with a specific focus on content and practical application. A total of 341 articles were identified.</p><p><strong>Results: </strong>A total of 20 studies using EMA to assess daily activities in neurological populations were included; most were observational, with 2 longitudinal studies and 2 randomized controlled trials. Daily activity questions and response formats varied, often using multiple-choice lists; only 1 study allowed open-ended responses. In addition to daily activity questions, EMA captured person (physical, affective, and cognitive), environment (physical and social), and occupation domains, as well as motivation and EMA disturbance. Protocols differed in setting, schedule, technology, and adherence, with most reporting completion rates above 70%.</p><p><strong>Conclusions: </strong>EMA captures daily activities in neurological populations and demonstrates generally high adherence despite variability in study designs, questions, and technologies. The findings suggest that the phrasing of EMA items, the predominance of closed-response formats, and the narrow focus on the verb \"doing\" limit the depth and nuance of the data collected, often overlooking important aspects of performance, engagement, or both in daily activities.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e92797"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761712","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":"Comparing the Feasibility of S-Patch vs 24-Hour Holter in Frail Older People With Falls: Randomized Open-Label Crossover Pilot Study.","authors":"Barbara Rosario, Vern Hsen Tan, Vivian Cantiller Barrera, Hnin Tun Mon, Clara Yi-En Seah, Colin Yeo","doi":"10.2196/81761","DOIUrl":"https://doi.org/10.2196/81761","url":null,"abstract":"<p><strong>Background: </strong>Falls commonly cause injuries in older adults and can present with syncope or presyncope. Typically, frail older adults with cognitive impairment are underrepresented in research and experience difficulty tolerating conventional ECG monitoring devices. S-Patch is a novel, lightweight dual-lead device designed to provide continuous ECG monitoring for up to 72 hours with minimal interference to daily activities.</p><p><strong>Objective: </strong>This study aimed primarily to evaluate the feasibility, tolerability, and adherence of the S-Patch compared with standard 24-hour Holter monitoring in older adults (aged ≥60 years) presenting with unwitnessed falls, syncope, or near-syncope, as assessed by wear duration, completion rates, and patient-reported experience. The secondary objective of this study was to assess device usability and compare arrhythmia detection rates between the devices in a real-world setting.</p><p><strong>Methods: </strong>This prospective, single-center, randomized, open-label, crossover feasibility pilot study was conducted from March 8, 2020, to February 28, 2023. Participants were randomized 1:1 into group A (Holter followed by S-Patch) or group B (S-Patch followed by Holter), enabling up to 4 days of continuous monitoring.</p><p><strong>Results: </strong>Seventy patients were enrolled, of whom 32 (45.7%) had cognitive impairment, and the majority were frail. Group A participants were older (86.9 vs 82.9 years) with higher use of dementia medications (6/35, 17.1% vs 3/35, 8.6%). Frailty was highly prevalent across the cohort, and fear of falling was significantly greater among frail patients (P=.04). Both devices were well tolerated, with no difference in overall device preference, but S-Patch enabled substantially longer monitoring durations compared to Holter. Mean S-Patch wear time exceeded 60 hours and was significantly longer when the device was applied first (68.8 vs 62.9 h; P=.04), suggesting acceptance and adherence. Importantly, tolerability was maintained in frail patients with cognitive impairment. Arrhythmia detection rates were observed as comparable, with both devices identifying one clinically significant arrhythmia, resulting in pacemaker implantation.</p><p><strong>Conclusions: </strong>S-Patch is a feasible, well-tolerated cardiac monitoring device in frail older adults and those with cognitive impairment. Compared with Holter, S-Patch supported longer continuous monitoring without compromising patient acceptability, an important consideration in real-world clinical practice.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e81761"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765476","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":"Iterative Development and Usability Evaluation of an Open-Source Rehabilitation Follow-Up Platform: User-Centered Development Study.","authors":"Noora Emilia Angelva, Franziska Gurschler, Michael Single, Valerie Frischknecht, Dominik Näf, Noel Kampus, Eva Cioffi, Thimo Marcin, Branislav Savic, Matthias Wilhelm, Anke Scheel-Sailer, Anna Lisa Martin-Niedecken, Urs Mosimann, Tobias Nef","doi":"10.2196/100614","DOIUrl":"https://doi.org/10.2196/100614","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation frequently extends beyond supervised clinical settings, creating a demand for scalable digital tools to support structured follow-up. We propose a novel open-source telerehabilitation platform.</p><p><strong>Objective: </strong>We describe the iterative, user-centered development of an open-source rehabilitation follow-up platform and report findings from an initial formative usability evaluation with patients, health care professionals, and additional end users.</p><p><strong>Methods: </strong>The platform was developed through repeated cycles of stakeholder engagement, prototyping, and evaluation within the rehabilitation department of Insel Group, University of Bern. A formative usability evaluation was conducted with 24 participants (8 health care professionals, 9 patients, and 7 additional participants; mean age 41.1, SD 12.9 y) using a task-based protocol. Perceived usability was assessed with the System Usability Scale (scored 0-100) and the Post-Study System Usability Questionnaire (scored 1-7; higher is better). Open-ended written responses were processed by one researcher using rapid content analysis.</p><p><strong>Results: </strong>A web-based telerehabilitation platform enables therapists to manage patient caseloads, assign and track personalized rehabilitation interventions, and monitor patient progress through Fitbit activity data and rehabilitation plan adherence. It supports multiclinic workflows with role-based access, REDCap patient importing (Vanderbilt University), automated background processing via Celery, and multilingual content. Its mean System Usability Scale score was 82.8 (SD 14.1), placing the platform in the \"excellent\" usability range. The mean Post-Study System Usability Questionnaire overall score was 6.02 (SD 0.77), with all 3 subscales scoring above 5.7. Most participants (20/24, 83%) rated the task set as easy or very easy; no participant rated any task as difficult. Among health care professionals, 7 out of 8 (88%) reported an intention to use the platform in practice. Qualitative themes highlighted the value of a rehabilitation plan overview, structured intervention scheduling, and progress tracking.</p><p><strong>Conclusions: </strong>The platform, released as open-source (Massachusetts Institute of Technology [MIT] License), demonstrated promising perceived usability across both patient and clinician user groups in a formative evaluation. These findings provide preliminary support for the platform's perceived usability and justify further evaluation in real-world rehabilitation settings. Future work will evaluate deployment in real-world outpatient settings and assess clinical effectiveness.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e100614"},"PeriodicalIF":3.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762260","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":"Usability and Functional Outcomes of the Obi3 Robotic Feeding Device Among People With Disabilities, Caregivers, and Providers: Mixed Methods Study.","authors":"Andrea D Fairman, Ryan B Osal, Heather Keeton, Jonathan P Dekar","doi":"10.2196/86338","DOIUrl":"10.2196/86338","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Loss of self-feeding ability due to severe bilateral upper extremity motor impairment (BUEMI) limits functional independence with a critical activity of daily living, increases medical risks, reduces social participation, and affects overall well-being. Robotic feeding devices are an emerging category of assistive technology. Obi3 is a third-generation, robotic feeding device, regulated in the United States as a Class I medical device and CE marked as a Class I device under the European Union Medical Device Regulation. The device is designed to enable people with BUEMI to independently select and safely consume food and liquid using accessible switches or interfaces while maintaining culturally normative dining practices. Although earlier Obi generations showed promise, comprehensive usability data across multiple stakeholder groups remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the usability, safety, and clinical relevance of Obi3 in real-world use from the perspectives of people with BUEMI, caregivers, and rehabilitation providers. The findings were intended to generate evidence to inform clinical decision-making and determinations of medical necessity for potential DME coverage, consistent with the device's intended use and clinician-assessed implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods usability study provided a 1-week home trial of Obi3. Quantitative measures included the System Usability Scale (SUS), survey items adapted from the Matching Person and Technology (MPT) framework, and self-feeding ratings based on the International Classification of Functioning, Disability, and Health impairment scale. Paired-sample t tests, Wilcoxon signed-rank tests, and effect sizes (Cohen d) assessed changes in self-feeding scores. Qualitative data from open-ended survey responses and follow-up semistructured interviews were analyzed thematically to complement quantitative findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 50 participants were enrolled, of whom 42 completed follow-up surveys. Participants included 15 people with BUEMI (pediatric and adult), 14 caregivers, and 13 providers. Participants' mean self-feeding impairment scores decreased significantly from 3.80 (SD 0.41) at baseline to 0.60 (SD 0.74) post trial (n=15; t&lt;sub&gt;14&lt;/sub&gt;=10.75; P&lt;.001; Cohen d=3.40). All patient participants demonstrated improvement in functional self-feeding ability. Mean SUS scores exceeded the benchmark for acceptable usability (≥68) across stakeholder groups: 82.8 (SD 17.2) for people with BUEMI, 85.2 (SD 12.6) for caregivers, and 85.0 (SD 10.7) for providers. Responses to MPT items indicated strong alignment between user goals and device capabilities, perceived safety, and low complexity. Caregivers reported reduced feeding-related workload and stress, and providers endorsed ease of clinical integration. No adverse events or device malfunctions occurred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/str","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e86338"},"PeriodicalIF":3.1,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727152","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}