JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Smartphone-Supported Vestibular Rehabilitation in Individuals With Vestibular Dysfunction: Pilot Randomized Crossover Trial Assessing Functional Clinical Outcomes and Anxiety.","authors":"Azriel Kaplan, Liran Kalderon, Amit Wolfovitz, Yoav Gimmon, Shelly Levy-Tzedek","doi":"10.2196/84207","DOIUrl":"10.2196/84207","url":null,"abstract":"<p><strong>Background: </strong>Vestibular disorders impair balance, increase fall risk, and reduce quality of life due to dizziness and vertigo. They are frequently accompanied by heightened anxiety, which may further limit daily functioning and contribute to avoidance behaviors. Although vestibular rehabilitation has been extensively studied and shown to be effective in managing vestibular disorders, adherence to home-based exercises remains low for many dizzy patients. This is often attributed to uncertainty about correct performance, lack of feedback, or difficulty maintaining a structured routine. To help address these barriers, Vestibulon, a smartphone app co-designed with clinicians and patients, was developed to support rehabilitation practice by providing guided exercise, structured scheduling, progress monitoring, and clear instructions intended to promote confidence and engagement.</p><p><strong>Objective: </strong>We aim to evaluate the potential contribution of a smartphone-based app to vestibular rehabilitation outcomes and to explore the relationship between dizziness-related disability and anxiety during the intervention.</p><p><strong>Methods: </strong>This randomized 2-period crossover pilot trial included 20 adults with vestibular dysfunction (mean age 52, SD 12 y) who completed 6 weeks of rehabilitation. Participants were randomized to begin with either app-supported or conventional treatment before crossing over to the alternate condition after 3 weeks. This design enabled each participant to experience both modes of rehabilitation. Assessments were conducted at baseline (T0), mid-study (after 3 wk; T1), and end of study (T2). Outcome measures included the Dizziness Handicap Inventory (DHI) to assess dizziness-related disability, the State-Trait Anxiety Inventory to evaluate anxiety, and the Instrumented Timed Up and Go test to quantify functional mobility. The primary outcome was the change in DHI scores across time points.</p><p><strong>Results: </strong>Significant improvements in DHI were observed between T0 and T2 in both groups (median change: app first=34, IQR 6-35 points, P=.006; conventional first=18, IQR 10-19 points, P=.009). Improvement in Instrumented Timed Up and Go performance was observed only when the app-supported phase occurred first (Z=-2.45, P=.01), suggesting a potential early benefit of structured smartphone guidance. State-Trait Anxiety Inventory scores did not change significantly in either sequence. Across all time points, dizziness-related disability and state anxiety demonstrated a consistent and significant moderate correlation (r=0.64, P<.001), emphasizing the strong interplay between physical and psychological symptoms in individuals with vestibular disorders.</p><p><strong>Conclusions: </strong>This pilot study indicates that smartphone-supported vestibular rehabilitation has the potential to enhance functional outcomes for some patients. The consistent association between dizziness and anxiety","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e84207"},"PeriodicalIF":3.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13022543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522199","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":"Technology-Driven Group Exercise Program Implementation in an Underserved Community: Multimethod Retrospective Evaluation Study.","authors":"Whitney N Neal, Laurie A Malone","doi":"10.2196/79598","DOIUrl":"10.2196/79598","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity among people with disabilities and older adults is a persistent public health concern, particularly those from racial minority groups living in underserved communities where structural barriers limit access to exercise opportunities. Technology-driven exercise programs offer scalable solutions, but the contextual factors that influence their uptake, fidelity, and sustainability remain underexplored.</p><p><strong>Objective: </strong>This study applied the Consolidated Framework for Implementation Research (CFIR) to identify barriers, facilitators, and lessons learned during the implementation of 2 technology-driven group exercise programs-synchronous online fitness and active virtual reality gaming-delivered to predominantly African American older adults with disabilities and/or chronic health conditions in an underserved community.</p><p><strong>Methods: </strong>Using a multimethod design, we conducted semistructured interviews and focus groups with program participants, staff, and administrators (n=15) and administered implementation surveys to program deliverers (n=9). Qualitative data were analyzed deductively using CFIR domains and constructs, while survey data provided descriptive context.</p><p><strong>Results: </strong>Both programs achieved high acceptability and appropriateness scores, with feasibility rated slightly lower for virtual reality. Themes mapped to 4 CFIR domains (innovation, outer setting, inner setting, and individuals). Qualitative analysis identified adaptability, affordability, engaging design, and community support as key facilitators, while barriers included technology and space constraints, resistance to new technology, and sustainability challenges.</p><p><strong>Conclusions: </strong>Technology-driven exercise programs can expand access to physical activity in underserved communities when they are adaptable, affordable, and socially engaging. Addressing multilevel barriers, including resource limitations, technology hesitancy, and long-term sustainability, is critical to scaling and sustaining these interventions.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e79598"},"PeriodicalIF":3.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515508","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 Therapeutic Conversational Agent (Solace) for Management of Chronic Pain: Acceptability and Usability Study.","authors":"P Maxwell Slepian, Stephanie Buryk-Iggers, Anna M Lomanowska, Binh Nguyen, Tahir Janmohamed, Hance Clarke, Joel Katz, Nils G Niederstrasser","doi":"10.2196/87689","DOIUrl":"10.2196/87689","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a critical cause of personal suffering and societal concern. However, treatment options remain inadequate, and access to efficacious treatment is limited by geography, economics, and scale. Digital health interventions for chronic pain are easily scaled solutions to this problem, and autonomous conversational agents represent a new frontier in this treatment domain. Despite their potential impact, conversational agents powered by generative artificial intelligence (AI) have yet to be developed or examined for the treatment of chronic pain.</p><p><strong>Objective: </strong>We aimed to develop and test Solace, a first-of-its-kind, expert-trained generative AI conversational agent designed to deliver support grounded in principles of evidence-based pain psychology.</p><p><strong>Methods: </strong>We conducted an acceptability and usability study of Solace in a group of individuals with chronic pain. Participants (n=175) were recruited from Prolific, an online crowdsourcing platform, and interacted with Solace for at least 25 minutes. Self-report measures of system usability, treatment acceptability, and therapeutic alliance were completed after the interaction, and clinically relevant pain-related measures were completed before and after the interaction.</p><p><strong>Results: </strong>Participants rated the usability of Solace to be excellent (System Usability Scale mean score 85.04, SD 13.6) and found it to be an acceptable intervention for chronic pain. The therapeutic alliance between participants and Solace was rated highly. Participants also demonstrated improvements in anxiety, pain interference, kinesiophobia, and pain resilience. Safety guardrails designed to identify and manage instances of suicidal ideation, injury, or requests for medication recommendations performed appropriately during the study. Solace is a usable and acceptable treatment for chronic pain that facilitates forming a strong therapeutic alliance with users. A single 30-minute conversation with Solace was also associated with improvements in several clinically relevant domains.</p><p><strong>Conclusions: </strong>Solace is a usable and acceptable expert-trained generative AI conversational agent for pain management. Randomized clinical trials are needed to evaluate the efficacy of Solace as a strategy for the treatment of chronic pain.</p><p><strong>Trial registration: </strong>OSF Registries osf.io/9c7tv; https://osf.io/9c7tv.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e87689"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228918","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":"Patient-Perceived Factors Influencing Physical Activity Sensor Use in Stroke Prevention and Rehabilitation: Systematic Review of Qualitative Studies Using Thematic Synthesis.","authors":"Paul Harris, Ingrid Maine","doi":"10.2196/86915","DOIUrl":"10.2196/86915","url":null,"abstract":"<p><strong>Background: </strong>A robust correlation exists between physical activity (PA) and stroke risk reduction, and wearable PA sensors have emerged as promising adjuncts for rehabilitation and risk self-management. However, evidence regarding their long-term efficacy in facilitating sustained behavioral change remains equivocal.</p><p><strong>Objective: </strong>This study aimed to explore the barriers and facilitators influencing the effective use of PA sensors in older adults at risk of primary or recurrent stroke.</p><p><strong>Methods: </strong>A systematic search and thematic synthesis of qualitative research was conducted, focusing on PA sensor use among older adults at risk of primary or recurrent stroke. Given the emerging qualitative evidence base, inclusion was extended to proxy populations with analogous cardiovascular risk and functional profiles. Data were analyzed using line-by-line coding of primary text to generate descriptive themes and synthesize overarching analytical constructs.</p><p><strong>Results: </strong>A search of 6 bibliographic databases (January 2010 to December 2023) identified 18 eligible studies. This systematic review and thematic synthesis revealed predominantly technological (user experience and device attributes) and psychological (motivation) barriers. Key facilitators were psychological (feedback and motivation), technological (user experience), and social/environmental supports. Higher-level analysis revealed a critical interrelationship between effective user engagement and optimally assistive device characteristics.</p><p><strong>Conclusions: </strong>This review revealed a synergistic user-device interaction driving sustained PA in older adults at risk of primary or recurrent stroke. Future interventions developed in collaboration with patients and informed by the factors identified by this study will improve participation in rehabilitation and functional outcomes in this population.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e86915"},"PeriodicalIF":3.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445302","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":"Comparison of Upper Body Joint and Hand Motions in Eating Solid Foods With Chopsticks and Semisolid Foods With a Spoon in Healthy Males and Females: Observational Study.","authors":"Jun Nakatake, Shogo Maeda, Shigeaki Miyazaki, Hideki Arakawa, Etsuo Chosa","doi":"10.2196/76239","DOIUrl":"10.2196/76239","url":null,"abstract":"<p><strong>Background: </strong>Foods are not only masticated and swallowed but they also influence the choice of utensils and their use. Comparing the contexts in which different utensils are used with each food form could help in the assessment of individuals experiencing eating difficulties in the food culture unique to East Asian countries.</p><p><strong>Objective: </strong>Considering East Asian rehabilitation practices, in this study, we evaluated upper body movements involved in eating pickles (solid food) and yogurt (semisolid food) using chopsticks and a spoon, respectively.</p><p><strong>Methods: </strong>Upper body kinematics, including joint and hand spatiotemporal parameters, were quantified using a 3D inertial motion-capturing system and analyzed in healthy males (n=22; mean age 27.9, SD 5.5 years) and females (n=21; mean age 26.9, SD 4.7 years) across 4 feeding phases (reaching, picking it up, transporting, and inserting food into the mouth) by comparing utensils for eating respective food forms using the Wilcoxon signed rank test.</p><p><strong>Results: </strong>Both sexes showed smaller maximum shoulder flexion angles with chopsticks for eating solid food across all phases (Males: reaching phase, P<.001; picking foods up phase, P=.04; transport phase, P<.001; and mouth phase, P<.001. Females: reaching phase, P<.001; picking foods up phase, P=.007; transport phase, P<.001; and mouth phase, P<.001.). Elbow, forearm, and wrist ulnar deviation angle changes were smaller using chopsticks during the \"picking up\" phase (in both sexes, P<.001) compared with using a spoon. However, greater elbow joint angle changes were found during the \"reaching\" phase (males, P=.002; females, P=.03) and greater forearm angle changes were found during the \"transporting\" phase (males, P=.01; females, P=.001) with chopsticks than with spoons. Regarding hand spatiotemporal parameters, the chopstick condition involved shorter actual distances (males, P<.001; females, P<.001), lower distance efficiency (males, P=.04; females, P=.001), and slower speed (males, P=.001; females, P<.001) during food transport.</p><p><strong>Conclusions: </strong>The joint angle and hand spatiotemporal parameter characteristics observed during chopstick use for eating solid foods and spoon use for eating semisolid foods in healthy individuals could serve as reference movements in individuals with sensorimotor dysfunctions and inform the selection of adaptive utensils in rehabilitation practice.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e76239"},"PeriodicalIF":3.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435886","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":"Evaluation of a Stretching Forearm Sleeve for Lateral Epicondylitis: Repeated Measures Study.","authors":"Adriana M Ríos Rincón, Christine Guptill, Ann Tran, Rija Kamran, Salamah Alshammari, Antonio Miguel Cruz","doi":"10.2196/80400","DOIUrl":"10.2196/80400","url":null,"abstract":"<p><strong>Background: </strong>Lateral epicondylitis (LE) is a condition that impairs daily activities due to pain exacerbated by wrist and hand movements. The ArmLock sleeve is a novel, nonsurgical intervention to stretch the wrist extensor muscles by maintaining the elbow in extension, forearm in pronation, and wrist and fingers in flexion.</p><p><strong>Objective: </strong>This study aimed to assess the effectiveness of sustained tension provided by the ArmLock sleeve on pain and functional outcomes in adults with LE. This novel device supports the forearm by aligning the elbow in extension, the forearm in pronation, and the wrist in flexion, while keeping the metacarpophalangeal and proximal interphalangeal joints of fingers II-V flexed.</p><p><strong>Methods: </strong>A within-subjects repeated-measures design was used to assess outcomes at baseline, week 6, and week 12. Nineteen participants wore the device at home for 30 minutes daily for 12 weeks. Outcome measures were administered by research assistants and included pain intensity, pain-free grip strength, pressure pain threshold, pain during resisted wrist extension, and composite extensibility of wrist and finger extensors. Repeated-measures 1-way ANOVA and Friedman tests were conducted (α=.05), followed by post hoc comparisons (α=.017, Bonferroni correction).</p><p><strong>Results: </strong>Significant improvements were observed in 6 of 7 (85.7%) outcome variables, including increased muscle extensibility, enhanced grip strength, and reduced pain intensity. Participants reported decreased pain and functional disability in a self-reported questionnaire.</p><p><strong>Conclusions: </strong>Wearing the device daily for 12 weeks led to significant improvements in extensibility, grip strength, and pain reduction. Participants also reported decreased pain and disability. These results suggest that the ArmLock sleeve may support symptom relief and functional gains in individuals with LE. Larger, controlled studies are needed to confirm its effectiveness.</p><p><strong>Trial registration: </strong>ISRCTN Registry ISRCTN13309889; https://www.isrctn.com/ISRCTN13309889.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e80400"},"PeriodicalIF":3.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356834","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":"Barriers to Adoption of Electronic Low Vision Aids Among Eye Care Professionals in Jordan: Descriptive Cross-Sectional Study.","authors":"Areej Okasheh-Otoom","doi":"10.2196/87685","DOIUrl":"10.2196/87685","url":null,"abstract":"<p><strong>Background: </strong>Digital, smart, and electronic low vision aids (LVAs) have expanded options for visual rehabilitation and functional independence among people with visual impairment. However, adoption of these technologies remains limited, particularly in low- and middle-income countries such as Jordan, where access, affordability, and training resources may be constrained.</p><p><strong>Objective: </strong>To examine barriers to the adoption of electronic LVAs and identify factors associated with their use among eye care professionals in Jordan.</p><p><strong>Methods: </strong>A descriptive cross-sectional survey was conducted among 270 eye care professionals working in hospitals, rehabilitation centers, and private clinics across Jordan. The questionnaire assessed awareness, training exposure, institutional support, and perceived barriers related to electronic LVAs. Descriptive statistics and inferential analyses were used to examine adoption patterns and predictors, with statistical significance set at P<.05.</p><p><strong>Results: </strong>Of the 270 participants, 156 (57.8%) were optometrists, 78 (28.9%) were ophthalmologists, and 36 (13.3%) were low vision specialists. The mean age was 36 (SD 8) years, and the mean professional experience was 12 (SD 6) years. Overall, 117 of 270 (42.2%) participants reported current use or recommendation of electronic LVAs. The most frequently reported barriers were high device cost (n=213, 79%), lack of training (n=184, 68.1%), limited institutional support (n=173, 64%), and low patient awareness (n=154, 57%). In multivariable analysis, greater training exposure (odds ratio [OR] 1.82, 95% CI 1.31-2.53; P<.001), stronger institutional support (OR 1.48, 95% CI 1.12-1.96; P=.008), and higher awareness scores (OR 1.35, 95% CI 1.05-1.72; P=.02) were positively associated with aid adoption, whereas high device cost was negatively associated with aid adoption (OR 0.41, 95% CI 0.27-0.62; P<.001).</p><p><strong>Conclusions: </strong>Adoption of electronic LVAs among eye care professionals in Jordan remains limited. Cost, training exposure, and institutional support are key factors influencing uptake. These findings suggest that strengthening professional training and institutional support may facilitate broader integration of electronic LVAs into low vision rehabilitation services.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e87685"},"PeriodicalIF":3.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436464","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":"Enhancing Knee Joint Proprioception in Healthy Adults Through Exergame Training With Augmented Feedback: Randomized Controlled Pilot Trial.","authors":"Yiling Zhang, Luis Felipe García Arias, Hans Timmerman, Ming Cao, Elisabeth Wilhelm","doi":"10.2196/78525","DOIUrl":"10.2196/78525","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proprioception training is essential for restoring knee function in several medical conditions. Open kinetic chain (OKC) and closed kinetic chain (CKC) exercises are used in active movement interventions to enhance proprioception. Exergames, supported by wearable sensors, offer a solution by providing real-time feedback. Auditory feedback (AF) embedded in the serious game training has shown benefits in upper limb rehabilitation compared to visual feedback (VF) alone. However, the potential of AF in exergames that provide knee training is not known.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study presents an exergame platform aimed at enhancing knee joint proprioception through stretching and squatting exercises. The platform allows to provide feedback in 2 modes, namely, VF only and a combination of AF and VF. The AF indicates the joint position by adjusting the loudness of the sound. The VF maps the motion of the lower limb into the game space, where this information is used to control a game object. A randomized controlled trial with 14 participants compared AF to VF only. The hypothesis was that AF would improve knee joint position accuracy, enhancing neuromuscular coordination and lower limb stability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized controlled trial was conducted within 14 healthy volunteers to test the exergames for knee joint motor learning using augmented feedback. All participants were required to do a pretest consisting of half and full squats and two tasks, in which participants were asked to reproduce a 45-degree knee bend and to stretch their knee fully. After that, participants played 4 rounds of each of the 2 exergames. Then the tasks of the pretest were repeated. A 1-sided Mann-Whitney U test was conducted for answering whether AF has a positive effect on the ability of participants to accurately control the knee joint angle. In addition, we calculated the muscle synergies participants used to complete the exercises. Subjective gaming experience was assessed using the Intrinsic Motivation Inventory and the User Experience Questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14 participants were recruited, including 7 in the experimental group with AF, and 7 in the control group only with VF. The result of the Mann-Whitney U test demonstrated that augmented feedback improved knee joint accuracy compared to VF in both the CKC (statistics=41.0; P=.04) and OKC (statistics=42.0; P=.03) tasks. Additionally, muscle synergy analysis revealed high consistency in different muscle synergy patterns between groups across both game types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Augmented feedback significantly enhanced knee joint motor learning performance (reflected in the knee joint angle positioning ability) in both CKC and OKC exergame training. Consistent muscle synergy patterns across participants show that the developed exergames are suitable for knee training. Studies in patient populations are","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e78525"},"PeriodicalIF":3.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310971","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 the Origins and Factors of Burnout in Physical Medicine and Rehabilitation: Grounded Theory Analysis.","authors":"Robert Simpson, Eva Cohen, Stephanie Posa, Marina Wasilewski, Anthony Feinstein, Mark Bayley, Larry Robinson, Sarah Munce, Carolyn Steele Gray, Kristina Kokorelias","doi":"10.2196/80499","DOIUrl":"10.2196/80499","url":null,"abstract":"<p><strong>Background: </strong>Physician burnout is highly prevalent in Physical Medicine and Rehabilitation (PM&R), but its origins and drivers remain poorly understood.</p><p><strong>Objective: </strong>This study aims to explore the factors contributing to burnout among Canadian physiatrists.</p><p><strong>Methods: </strong>Using Charmaz's Constructed Grounded Theory within a qualitative interpretivist paradigm, we interviewed 30 Canadian physiatrists about their experiences with burnout. Analysis was informed by Cooley's looking-glass self theory.</p><p><strong>Results: </strong>Burnout in PM&R in Canada stems from a medical culture prioritizing academic excellence over compassionate care. Canadian physiatrists report shame and self-criticism when unable to meet these high standards. Retrospective accounts from Canadian physiatrists suggest that burnout peaks during residency, where autonomy is low and demands are high. Participants also described feeling unprepared to handle patients' emotional needs and experiencing moral distress when necessary care cannot be delivered due to systemic barriers. Health care bureaucracy further compounds burnout.</p><p><strong>Conclusions: </strong>Addressing burnout in PM&R in Canada requires upstream systemic and contemporary cultural change.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e80499"},"PeriodicalIF":3.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291247","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":"Reducing Educational Bias in Cognitive Assessment via Dynamic Support Vector Machine Weighting: Validation Study on an Education-Stratified Dataset.","authors":"Qing Liu, Chi Ma, Mengyuan Liu, Suhui Chen, Mengting Yu, Lijuan Xia, Qi Zhang, Ming Wu","doi":"10.2196/79841","DOIUrl":"10.2196/79841","url":null,"abstract":"<p><strong>Background: </strong>The Mini-Mental State Examination (MMSE) remains widely used for cognitive screening, yet its performance varies substantially across educational backgrounds. Linear education corrections fail to capture the nonlinear interference patterns among subitems.</p><p><strong>Objective: </strong>This study aimed to analyze how educational level shapes MMSE subitem contributions and to develop an education-adaptive optimization strategy using support vector machine-based weighting.</p><p><strong>Methods: </strong>MMSE data from 812 participants were stratified into 4 education groups. Subitem deletion experiments quantified each subitem's contribution (Δ). Education-specific support vector machine models were then constructed to derive dynamic weighting coefficients. Performance improvements were assessed before and after weighting.</p><p><strong>Results: </strong>The illiterate group relied heavily on spatial orientation and memory, whereas university-educated individuals depended more on executive and calculation functions. Several education-dependent interference items were identified (eg, visuospatial construction in the primary group and basic orientation tasks in the university group). Dynamic weighting improved accuracy in all cohorts, most notably among illiterate individuals (Δ=7.25%; P=.06), followed by the primary school group (Δ=3.12%; P=.03).</p><p><strong>Conclusions: </strong>Education-stratified weighting enhances the fairness and interpretability of MMSE-based screening. External validation confirmed generalizability, although multicenter studies are needed.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"13 ","pages":"e79841"},"PeriodicalIF":3.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291271","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}