JMIR Rehabilitation and Assistive Technologies最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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 >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 >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.</p><p><strong>Results: </strong>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}

{"title":"Personalized Predictions for Changes in Knee Pain Among Patients With Osteoarthritis Participating in Supervised Exercise and Education: Prognostic Model Study.","authors":"Mahdie Rafiei, Supratim Das, Mohammad Bakhtiari, Ewa Maria Roos, Søren T Skou, Dorte T Grønne, Jan Baumbach, Linda Baumbach","doi":"10.2196/60162","DOIUrl":"10.2196/60162","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a common chronic condition that impairs mobility and diminishes quality of life. Despite the proven benefits of exercise therapy and patient education in managing OA pain and functional limitations, these strategies are often underused. To motivate and enhance patient engagement, personalized outcome prediction models can be used. However, the accuracy of existing models in predicting changes in knee pain outcomes remains insufficiently examined.</p><p><strong>Objective: </strong>This study aims to validate existing models and introduce a concise personalized model predicting changes in knee pain from before to after participating in a supervised patient education and exercise therapy program (GLA:D) among patients with knee OA.</p><p><strong>Methods: </strong>Our prediction models leverage self-reported patient information and functional measures. To refine the number of variables, we evaluated the variable importance and applied clinical reasoning. We trained random forest regression models and compared the rate of true predictions of our models with those using average values. In supplementary analyses, we additionally considered recently added variables to the GLA:D registry.</p><p><strong>Results: </strong>We evaluated the performance of a full, continuous, and concise model including all 34 variables, all 11 continuous variables, and the 6 most predictive variables, respectively. All three models performed similarly and were comparable to the existing model, with R2 values of 0.31-0.32 and root-mean-squared errors of 18.65-18.85-despite our increased sample size. Allowing a deviation of 15 (visual analog scale) points from the true change in pain, our concise model correctly estimated the change in pain in 58% of cases, while using average values that resulted in 51% accuracy. Our supplementary analysis led to similar outcomes.</p><p><strong>Conclusions: </strong>Our concise personalized prediction model provides more often accurate predictions for changes in knee pain after the GLA:D program than using average pain improvement values. Neither the increase in sample size nor the inclusion of additional variables improved previous models. Based on current knowledge and available data, no better predictions are possible. Guidance is needed on when a model's performance is good enough for clinical practice use.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e60162"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674461","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":"Development of a Mobile App Game for Practicing Lung Exercises: Feasibility Study.","authors":"Chatkhane Pearkao, Korakot Apiratwarakul, Lerkiat Wicharit, Wiphawadee Potisopha, Arunnee Jaitieng, Sukuman Homvisetvongsa, Puthachad Namwaing, Peerapon Pudtuan","doi":"10.2196/63512","DOIUrl":"10.2196/63512","url":null,"abstract":"<p><strong>Background: </strong>Chest injuries are a leading cause of death and disability, accounting for 10% of hospital admissions and 25% of injury-related deaths. About two-thirds of patients with thoracic injuries experience complications such as blood or air in the pleural space, causing lung deflation and poor gas exchange. Proper breathing management, using tools like incentive spirometers, improves lung function and recovery. However, there is a gap in mobile-based gaming apps designed for lung exercise, which could benefit both the general population and patients recovering from lung injuries.</p><p><strong>Objective: </strong>This research aimed to develop and evaluate a mobile app game for practicing lung exercises, accompanied by a prototype device called the Pulmo device.</p><p><strong>Methods: </strong>The study involved a sample group of 110 participants from the general public. It followed a research and development methodology comprising 4 steps. The research instruments included a mobile app game, a prototype lung exercise device, and questionnaires to assess users' satisfaction and the feasibility of both the app and the device.</p><p><strong>Results: </strong>The findings revealed that the participants demonstrated a high level of overall satisfaction with both the mobile app game and the prototype lung exercise device (mean 4.4, SD 0.4). The feasibility for the mobile app game and the prototype lung exercise device connected to the game was evaluated. The results indicated that the sample group perceived the overall feasibility to be at a high level (mean 4.4, SD 0.5).</p><p><strong>Conclusions: </strong>The research results reflected that the sample group believed the mobile app game for practicing lung exercises and the prototype device developed in this project have a high potential for practical application in promoting lung rehabilitation through gameplay. The mobile app game and the Pulmo device prototype received positive user feedback, indicating potential practical use; however, further validation is required among patients in need of pulmonary rehabilitation.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e63512"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543706","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}