JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Use of Wearable Devices to Augment Traditional Measurements of Postoperative Outcomes Following Total Joint Arthroplasty: Systematic Review.","authors":"Robert Raymond Hall Iii, Alexander P Hamel, Pamela A Chan, Hua Zheng, David C Ayers","doi":"10.2196/84671","DOIUrl":"10.2196/84671","url":null,"abstract":"<p><strong>Background: </strong>Wearable devices enabling remote monitoring by surgeons of their patients have gained prominence around total joint arthroplasty (TJA), offering continuous patient data to identify those not meeting postoperative goals, thereby facilitating timely interventions. While multiple studies highlight the utility of these devices in tracking postoperative progress, a standardized approach to their application is lacking. This review aims to synthesize existing literature on the use of wearable device-tracked activity for monitoring TJA outcomes.</p><p><strong>Objective: </strong>We examined the current literature to evaluate how wearable devices are used in monitoring and improving patient rehabilitation and outcomes following TJA.</p><p><strong>Methods: </strong>A systematic review was conducted following Cochrane methodology. A literature search of all available literature was performed in April 2024 and identified 102 studies to undergo full-text review. Systematic reviews, duplicate papers, and theoretical papers were excluded. Ultimately, 35 studies met the selection criteria.</p><p><strong>Results: </strong>The review revealed that 32 of 35 (91.4%) studies used wearable devices to monitor step counts. A total of 21 (60%) studies incorporated joint-specific patient-reported outcome measures, though the specific measures varied. Further, 9 studies used standardized performance-based outcome measures, which also differed across studies. Finally, 7 (20%) studies collected sleep data; however, the methods and outcomes for sleep measurement were inconsistent among these studies.</p><p><strong>Conclusions: </strong>Remote monitoring via wearable devices offers a novel approach to tracking outcomes in TJA patients. Although the use of these devices in perioperative care is expanding, significant variability exists in the data reported across studies. Wearable monitoring is often integrated with patient-reported outcome measures and standardized functional assessments, yet the optimal data parameters that best correlate with established outcome metrics remain undefined. Additionally, data collected by wearables has not yet been shown to predict patient recovery or satisfaction. Further research is essential to refine these data parameters and the development of postoperative protocols that leverage wearable devices to enhance patient compliance and improve clinical outcomes.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e84671"},"PeriodicalIF":3.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718125","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 an Exercise-Assisting Mobile App (Osteoarthritis-Rehabilitation Assistant [O-RA]) on Rehabilitation Outcomes in Older Adults: Randomized Controlled Parallel Clinical Trial.","authors":"Pajaree Sornmayura, Sintip Pattanakuhar, Napaschol Intapan, Krittipat Tragoolpua, Kaewkla Sroykabkaew, Rungkan Wangboon, Krittipong Wachirangkul, Sartita Wannarat, Jakkrit Klaphajone","doi":"10.2196/80971","DOIUrl":"10.2196/80971","url":null,"abstract":"<p><strong>Background: </strong>Mobile apps and biofeedback using motion analysis have both been used separately to increase compliance with exercise programs. We developed a mobile app, Osteoarthritis-Rehabilitation Assistant (O-RA), that uses motion analysis technology in the mobile app to assist older adults with performing a knee exercise program.</p><p><strong>Objective: </strong>This study aimed to evaluate the effects of the O-RA app on the compliance and correctness of the exercise program by older adults.</p><p><strong>Methods: </strong>We conducted an assessor-blind, parallel-design, randomized controlled trial with 40 older adults (aged 60 years or older) who had no symptoms and no diagnosis of knee osteoarthritis. Participants were divided into 2 groups: O-RA app (intervention) group and standard treatment (control) group. Both groups were taught 4 types of exercise programs by a physical therapist for 15 minutes and were instructed to do exercises at home every day for 1 week. The number of exercises, the percentage between observed and prescribed exercises, the correctness of exercises, and overall pain during the program were assessed in both groups.</p><p><strong>Results: </strong>The control group had significantly higher compliance with the exercise program than the intervention group (t38=3.5044, P=.001). There was no statistically significant difference in the correctness of the exercise program between the intervention and control groups. The difficulty of use and satisfaction were 47 and 59, respectively, out of the full score of 100. The main problems were the instability and the difficulty using the app.</p><p><strong>Conclusions: </strong>In older adults without knee osteoarthritis symptoms or diagnosis, the O-RA app was not a facilitator but a barrier to the lower extremity exercise program. An updated version, aiming to increase the stability and make it more user-friendly, should be developed; however, more comprehensive data, including qualitative user feedback and standardized usability metrics, will be needed to effectively guide its design.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e80971"},"PeriodicalIF":3.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692456","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":"Evaluating the Feasibility of Technology-Based Interventions in Disability and Rehabilitation: Definitions, Considerations, and Dimensions.","authors":"Josh Shore, Amy S Hwang, Rosalie H Wang","doi":"10.2196/79026","DOIUrl":"10.2196/79026","url":null,"abstract":"<p><strong>Unlabelled: </strong>Technology-based interventions in the field of disability and rehabilitation, which serve assistive, therapeutic, and/or service delivery functions, are considered complex due to the skills required of providers and recipients, degree of individual tailoring, and diversity of use settings. Feasibility studies are an important step in the evolution of complex interventions that can help refine the intervention, inform implementation, and prevent wasted resources. However, guidance is lacking regarding specific considerations for feasibility studies of technology-based interventions in disability and rehabilitation, which leaves researchers and developers reliant on resources from other fields that do not address important technology properties. To advance the field, context-specific definitions, considerations, and evaluation dimensions must be explicitly outlined to ensure that feasibility studies are constructively designed to meet the unique needs of these interventions. In this viewpoint article, we (1) propose a definition and framework for feasibility studies within the specific context of technology-based disability and rehabilitation interventions, (2) highlight important and unique imperatives for feasibility studies of these interventions, and (3) articulate relevant feasibility dimensions and associated evaluation criteria for these interventions. Building on previous work, we distinguish between feasibility studies, wherein we focus on iterative intervention refinement by addressing key development questions (eg, usability), and pilot studies, which are small-scale versions of a larger study that will evaluate intervention outcomes. Integrating previous typologies, we present 13 feasibility dimensions relevant to technology-based interventions and provide sample evaluation criteria, focusing on the intervention itself rather than study design considerations (eg, trial management). This information may be useful for research and development communities (academic, clinical, or industry) to inform comprehensive feasibility studies that examine unique aspects of technology-based interventions to promote real-world impact. This contribution encourages greater harmonization of terminology and evaluation methods to streamline interpretation and comparison across studies.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e79026"},"PeriodicalIF":3.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692518","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 Smart Textile Biofeedback Training System for Upper Limb Rehabilitation After Stroke: Co-Design Development and Evaluation Study.","authors":"Maria Munoz-Novoa, Li Guo, Anna Björkquist, Morten B Kristoffersen, Peiman Khorramshahi, Leif Sandsjö, Margit Alt Murphy","doi":"10.2196/77999","DOIUrl":"10.2196/77999","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of rehabilitation technologies are being developed to support upper limb rehabilitation after stroke, with smart textile solutions for surface electromyography (sEMG) emerging as a promising approach. Early end-user involvement is crucial for developing user-friendly and clinically valid rehabilitation tools.</p><p><strong>Objective: </strong>This study aims to refine and evaluate the prototype design and usability of a smart textile biofeedback system for self-administered upper limb training after stroke.</p><p><strong>Methods: </strong>The training system includes a knitted smart textile sleeve with integrated electrodes over the forearm muscles, an sEMG unit, and tablet-based biofeedback software. An iterative co-design process was followed, including initial testing, demonstration sessions with end users (9 clinicians and 10 individuals with stroke), and a final evaluation of the co-design process. Participants' experiences were gathered through semistructured interviews, analyzed using content analysis, and the User Experience Questionnaire. The co-design team included experts in stroke rehabilitation, textile engineering, biomedical engineering, software development, and human factors, as well as a research partner with lived experience after stroke.</p><p><strong>Results: </strong>The perspectives of the end users and the expert team were collectively integrated into prototype refinements of the sleeve and training software to meet the needs of the intended target group. The experiences of end users formed 2 main categories: \"This could be an exciting new training tool for stroke rehabilitation\" and \"The tool works well, but some changes could enhance independent training.\" End users found the smart textile sleeve and biofeedback system easy to use and saw potential for integrating it into their training routines. Both end-user groups rated the system as attractive, stimulating, and novel.</p><p><strong>Conclusions: </strong>The results of this study establish a necessary ground toward the development of a smart textile sEMG biofeedback system for self-administered upper limb training after stroke. Findings from the co-design process support the continued development and evaluation of the system as a self-administered upper limb training tool for individuals living with stroke.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e77999"},"PeriodicalIF":3.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677225","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":"Design Implications of Comfort and Usability of Manual Stairclimbing Wheelchair: Ergonomic Assessment and Pilot Study Using Surface Electromyography Inputs.","authors":"Abhishek Verma, Rohit Kumar, J Ramkumar","doi":"10.2196/78965","DOIUrl":"10.2196/78965","url":null,"abstract":"<p><strong>Background: </strong>Stairclimbing wheelchairs offer enhanced mobility for users navigating multilevel environments, yet limited research addresses the ergonomics of lever propulsion-based stair climbing mechanisms. Comprehensive ergonomic assessment integrating both subjective user feedback and objective biomechanical analysis is essential for optimizing assistive device design for comfort and usability.</p><p><strong>Objective: </strong>This pilot study aims to assess the ergonomic design of a transformable stair-climbing wheelchair through a dual-methodology approach, evaluating plane surface movement accessibility and quantifying muscle activation patterns during lever-propelled stair-climbing operations using surface electromyography (sEMG).</p><p><strong>Methods: </strong>This 2-part study involved anthropometric measurements from 20 male participants to establish design parameters using 5th and 95th percentile values. Part A assessed plane surface movement with 9 participants (7 healthy, 2 with paraplegia) navigating a simulated urban course featuring a 5° ramp, a 90° turn, and narrow passages across 3 trials. Task completion times and subjective ride easiness ratings were recorded. Part B used a Taguchi-based fractional factorial design to evaluate 3 ergonomic factors, including torso angle (λ), lever distance (L), and lever orientation (ψ), across 7 healthy participants. Maximum voluntary contraction (MVC) was measured for 4 muscles, including biceps brachii long head (BBL), triceps brachii long head (TBL), brachioradialis, and posterior deltoid (PDT).</p><p><strong>Results: </strong>In Part A, the ramp and 90° turn proved most challenging due to the wheelchair's 65 kg weight and large turning radius (~1450 mm). Driving control scored highest (6/10), while comfort scored lowest due to the tilted seat design. In Part B, a straight torso (λ=0°) consistently reduced muscle strain, particularly for brachioradialis. A lever distance of approximately 50 mm and a neutral to slightly supinated orientation (ψ=0°-30°) optimized muscle effort. Interaction effects revealed high strain configurations (λ=45°; L=100 mm; ψ=-30°) exceeding 75 MVC, while optimal settings reduced strain to approximately 50 MVC.</p><p><strong>Conclusions: </strong>Optimal ergonomic parameters of λ=0°, L=37.5 mm, and ψ=15° are recommended to minimize fatigue and enhance user comfort. Design improvements should prioritize weight reduction, compact form factor for maneuverability, and adjustable seat tilt. The modular wheelchair design permits customization for diverse user populations. Future research should include larger, gender-diverse participant groups and real-world validation studies.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e78965"},"PeriodicalIF":3.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677300","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 Social Justice Approach to Assistive Technology and Well-Being of People With Visual Disabilities in Low- and Middle-Income Countries: Qualitative Narrative Study.","authors":"Luisa Maria Ortiz-Escobar, Mario Andres Chavarria, Samia Hurst-Majno, Oscar Ivan Campo Salazar, Celia Escobar-Hurtado, Michael Ashley Stein, Minerva Rivas Velarde","doi":"10.2196/72306","DOIUrl":"10.2196/72306","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The United Nations' third Sustainable Development Goal emphasizes ensuring healthy lives and promoting well-being (WB) for all, which requires effective assistive technology (AT) for persons with disabilities. In low- and middle-income countries (LMICs), however, AT remains largely inaccessible, and high abandonment rates indicate that many existing solutions fail to meet users' needs. To improve AT design and effectiveness, a deeper understanding of users' lived experiences and the ways AT influences WB is essential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore how technology creates opportunities or barriers in the daily lives of persons with visual disabilities in LMICs and how it affects their WB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative narrative study guided by deductive qualitative analysis, using the capability approach (CA) and disadvantage theory (DT) as theoretical frameworks. Nineteen adults with visual disabilities from Cali, Colombia, participated in in-depth, semistructured interviews. A focus group (n=5) deepened the exploration of shared experiences. Data analysis followed three stages: (1) deductive coding using Nussbaum list of central capabilities and key CA constructs (functionings, conversion factors, and agency); (2) recoding through DT concepts (insecure functioning, corrosive disadvantages, and fertile functionings); and (3) inductive analysis to capture emergent sociocultural themes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AT shaped both opportunities and constraints in participants' lives. While functionings such as employment, mobility, and affiliation were highly valued, they often remained insecure due to systemic barriers. Corrosive disadvantages-such as unemployment, exclusion, and limited spatial autonomy-undermined multiple capabilities simultaneously. Conversely, fertile functionings such as equitable employment, adaptive sports, and access to well-designed AT supported agency and resilience. The inductive analysis revealed 3 interconnected themes: the aspiration to explore and expand movement, the desire to appear attractive, and the adoption of nonconfrontational strategies to maintain social harmony. These findings highlight how emotional, aesthetic, and cultural dimensions shape the experience and meaning of AT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;While AT research in LMICs often emphasizes availability, it rarely addresses how social norms, structural violence, and fear affect meaningful use. The combined CA and DT lens reveals that AT can either enable or constrain WB depending on how it aligns with users' lived contexts. Designing for fertile functionings-those that support agency, safety, and resilience-is essential. Participatory, context-sensitive design must prioritize not only functionality, but also aesthetic dignity, cultural relevance, and emotional security. Including the voices-and silences-of persons with disabilities in the Global Sout","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e72306"},"PeriodicalIF":3.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13060747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639723","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":"Reliability and Discriminant Ability of an Instrumented Timed Up and Go Test in People With Postsurgical Orthopedic Conditions: Quantitative Study.","authors":"Marica Giardini, Ilaria Arcolin, Valerio Antonio Arcobelli, Michela Picardi, Sabato Mellone, Marco Godi","doi":"10.2196/82632","DOIUrl":"10.2196/82632","url":null,"abstract":"<p><strong>Background: </strong>The Timed Up and Go (TUG) test is widely used to assess mobility and fall risk in older adults and orthopedic patients. Its instrumented variant (iTUG), based on inertial measurement units, enables an objective quantification of motor performance and can even be implemented using smartphone technology. However, its broader clinical adoption remains limited by concerns about reliability, feasibility, and the interpretability of the extracted parameters.</p><p><strong>Objective: </strong>This study aimed to evaluate the test-retest reliability of variables derived from a single-sensor iTUG in orthopedic inpatients undergoing rehabilitation and to determine whether a subset of reliable sensor-based metrics can support a multidimensional assessment of functional mobility and discriminate among common orthopedic conditions.</p><p><strong>Methods: </strong>We recruited 104 inpatients at discharge from a rehabilitation ward after total hip arthroplasty, total knee arthroplasty, or femur fracture. Each participant performed the iTUG test on 2 consecutive days using a smartphone-based solution consisting of an inertial measurement unit placed on the lower back. From 100 extracted variables, those with excellent test-retest reliability (intraclass correlation coefficient ≥0.75) were retained. Exploratory factor analysis was used to identify underlying mobility domains, and linear discriminant analysis with 10-fold cross-validation tested their ability to classify diagnostic groups.</p><p><strong>Results: </strong>Out of 100 iTUG-derived variables, 36 demonstrated excellent test-retest reliability, and 25 were retained for multivariate analysis. Exploratory factor analysis identified 5 factors-walking ability, pace or rhythm, sit-to-walk smoothness, turning ability, and mediolateral angular stability-explaining 80.8% of the total variance. These factors showed good classification accuracy (68%) and achieved an area under the curve of 0.86 and an overall mean accuracy of 0.68 (SD 0.14) for distinguishing among total hip arthroplasty, total knee arthroplasty, and femur fracture. In contrast, total iTUG duration alone yielded an area under the curve of 0.62. All patients used walking aids, and gait variables were more reliable than jerk-based or coordination metrics.</p><p><strong>Conclusions: </strong>The single-sensor iTUG provides reliable and clinically informative metrics that go beyond traditional stopwatch timing, enabling a multidimensional view of functional mobility in orthopedic patients. The approach is feasible, interpretable, and compatible with real-world mobile health apps, supporting personalized rehabilitation monitoring and future integration into digital decision support systems.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e82632"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595021","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":"Appropriateness and Impact of a Vocal Cord Vibration Switch for Children with Complex Communication Needs: Case Series.","authors":"Leslie Mumford, Denise Guerriere, Tom Chau","doi":"10.2196/75626","DOIUrl":"10.2196/75626","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Communication is an essential component of participation. Communication impairment restricts full participation for children who have unintelligible speech. A vocal cord vibration switch offers an avenue for meaningful interaction to children who cannot rely on speech or voluntary limb movement but have some control of their vocal cords. Previous evaluations of the vocal cord vibration switch have been conducted primarily with adults and adolescents. However, implementation of a vocal cord vibration switch with younger, school-aged children in their natural environmental contexts can potentially foster the development of early communication skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This case series evaluated the appropriateness and impact of a vocal cord vibration switch, the \"Hummingbird\" (Holland Bloorview) with school-aged children who have complex communication needs and their mothers and teachers, using an individualized, collaborative, and iterative assistive device implementation protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Hummingbird was evaluated with 3 school-aged children, across educational and health-related contexts, over a 2-year period. Baseline, midterm, and final assessments took place at home or school in the first year with a follow-up assessment in the second year. In addition to field observations and device performance assessments by the research team, feedback from mothers and teachers was collected via questionnaires (Pictorial Children's Effort Rating Table, Quebec User Evaluation of Satisfaction with Assistive Technology, and the Family Impact of Assistive Technology Scale) to ascertain the Hummingbird's appropriateness and its impact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Appropriateness data indicated the suitability of the Hummingbird across settings. Compared to the child's prestudy devices, mother and teacher participants reported that the physical effort required by all 3 children to use the Hummingbird was lower (scores on the Pictorial Effort Rating Table decreased from 8 and 11 to scores of 4-6). The switch efficacy assessment of the Hummingbird indicated moderate-to-high specificity and high sensitivity at midterm and high sensitivity (0.91-0.94) and specificity (0.92-1) at final assessments. Total satisfaction scores increased from baseline (prestudy device) to the 2-year assessment for all 3 children. While data on the impact on family and communication were incomplete for 1 participant, generally favorable effects were reported. The field notes underscored the value of an individualized protocol, where the implementation and evaluation phases were adapted to accommodate the health-related characteristics (eg, seizure disorder and sleep deprivation), evolving school contextual factors (new school and teacher), and unique family environments (involving the child participant's toddler-sibling in Hummingbird sessions).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Overall, the Hummingbird was ","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e75626"},"PeriodicalIF":3.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595051","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":"Telerehabilitation Following Stroke: Development of Training Content and Evaluation of an App-Based Training Program.","authors":"Carina Ziller, Szabina Gäumann, Silya Lüscher, Nele Paulissen, Frank Behrendt, Zorica Suica, Björn Crüts, Luana Gamerschlag, Katrin Parmar, Hans Ulrich Gerth, Leo H Bonati, Corina Schuster-Amft","doi":"10.2196/77090","DOIUrl":"10.2196/77090","url":null,"abstract":"<p><strong>Background: </strong>Enhancing rehabilitation methods for patients with stroke is essential, particularly during the transition from inpatient to outpatient care. Digital applications are being developed to provide telerehabilitation programs. The existing virtual blended care platform Blended Clinic (Blended Clinic AI GmbH) offers app-based training for patients after a stroke and comprises 3 main components, including training, coaching, and monitoring.</p><p><strong>Objective: </strong>This study assesses the usability and user experience of the novel Swiss Tele-Assisted Rehabilitation and Training (START) program within the Blended Clinic platform in patients after stroke and therapists.</p><p><strong>Methods: </strong>The START program was developed within 3 workshops and an online survey. It contains 10 6-week exercise programs tailored to the levels of the modified Rankin Scale (mRS), 5 infographics, and 5 podcasts. Eight patients after stroke and 10 therapists took part in a single-center usability study. All participants were introduced to the Blended Clinic app and subsequently used it independently. The Blended Clinic platform, including the START program, was evaluated by both user groups based on the System Usability Scale (SUS) and the Mobile App Rating Scale (MARS-G). Additionally, feedback was collected, observations were documented, and program adherence metrics were calculated.</p><p><strong>Results: </strong>The mean SUS scores were 87.2 (SD 10.8) for 8 patients and 83.3 (SD 11.3) for 10 therapists. The MARS-G scores were 3.9 (SD 0.5) for patients and 4.1 (SD 0.4) for therapists for categories A-D. User experience was rated 4.1 (SD 0.5) for patients, while device usability was 3.8 (SD 0.8) for patients and 4.2 (SD 0.5) for therapists. Adherence to the training schedule varied among patients (16.7%-80% of the planned sessions) and was rather low for many of the patients.</p><p><strong>Conclusions: </strong>The START program, delivered via the Blended Clinic platform, was considered user-friendly and received good usability ratings from patients with stroke and therapists. Recommendations to enhance compliance are provided.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e77090"},"PeriodicalIF":3.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595034","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":"Using Natural Language Prompts With AI Models for Low-Cost Assistive Software Design: Exploratory Comparative Evaluation.","authors":"Francesc Antoni Bañuls-Lapuerta, Vicent Marti-Miralles, Rómulo Jacobo Gónzalez-García, Gabriel Martínez-Rico","doi":"10.2196/86786","DOIUrl":"10.2196/86786","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the capacity of 7 artificial intelligence (AI) models, 5 free and 2 paid, to generate functional software for designing low-cost, personalized assistive products.</p><p><strong>Objective: </strong>The objective was to determine which models are most effective, accessible, and consistent in supporting nontechnical professionals in developing inclusive digital solutions and to assess the capabilities of commercially available and easy-to-access AI models to generate code from natural language interactions in the shape of a nontechnical assistive technology design process.</p><p><strong>Methods: </strong>Each AI model was prompted using natural language, without any technical input, to create a Python program that converts an arcade gamepad into an adapted mouse-like controller. Sixteen progressively complex functions were requested through standardized prompts, delivered without additional feedback or correction. Model performance was evaluated based on the number of successfully implemented functions and the average number of prompts required.</p><p><strong>Results: </strong>Paid models demonstrated markedly superior performance. Gemini Pro (Google) successfully implemented 14 of 16 requested functions with an average of 1.25 (SD 0.45) prompts, while ChatGPT Plus (GPT-5) achieved 11 functions with an average of 1.31 (SD 0.48) prompts. In contrast, free models produced between 0 and 4 functional outcomes, with DeepSeek and Gemini Free ranking the highest within their category. The enhanced outcomes of paid models were linked to improved contextual understanding, greater tolerance for natural language, and reduced conversational drift.</p><p><strong>Conclusions: </strong>Paid AI models, particularly Gemini Pro and ChatGPT Plus, exhibit strong potential as tools for bridging the gap between health or education professionals and software development. They enable the creation of affordable, user-centered assistive technology without requiring advanced programming skills. Nevertheless, human oversight and foundational literacy in prompt design remain crucial to guarantee functionality, reliability, and ethical use.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e86786"},"PeriodicalIF":3.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515494","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}