Rehabilitation technologies perceived positively by patients and facilitated intensive therapy within sessions.

Background: Traditionally, auditory rehabilitation in people with hearing loss has sought training in auditory skills to achieve an understanding of sound messages for communication. Assistive or supportive technology is limited to hearing aids that transmit sound through the air or bone to be used by the individual, and only in recent times have technologies for rehabilitation, of high cost and difficult access, begun to be used, employed by audiology professionals. Objective: The objective of this study was to compile the evidence reported in the literature on the use of technology in auditory rehabilitation for the improvement of hearing skills in people with hearing loss, beyond hearing aids and cochlear implants. Method: A systematic review of the literature was conducted between 2018 and 2024 in PubMed, Scopus, and Web of Science databases, using as search terms Technology AND “Auditory Rehabilitation” validated in DeCS and MeSH thesauri; the PICO method was used to propose the research question, and the PRISMA strategy was used for the inclusion or exclusion of the articles to be reviewed. Results: In the first search, 141 documents were obtained. Subsequently, inclusion criteria, such as development with vibrotactile stimulation, Information and Communication Technologies (ICTs), among others, and exclusion criteria, such as those related to cochlear implants and air conduction hearing aids, were applied, and finally, articles related to natural language processing, and other systematic reviews were excluded so that the database was reduced to 14 documents. To this set, due to their relevance, two papers were added, for a total of sixteen analyzed. Conclusions: There are solutions ranging from the use of smartphones for telehealth to solutions with multiple technologies, such as the development of virtual environments with vibrotactile feedback. Hearing-impaired people and even professionals in this area of healthcare have a high level of acceptance of the use of technology in rehabilitation. Finally, this article highlights the crucial role of technology in auditory rehabilitation, with solutions that improve hearing skills and the positive acceptance of these tools by patients and audiology professionals.

Exploring the reasons behind the low focus on upper limb rehabilitation in the early stages after a stroke: A qualitative study

BackgroundNeurorehabilitation engineering faces numerous challenges to translating new technologies, but it is unclear which of these challenges are most limiting. Our aim is to improve understanding of rehabilitation therapists’ real-time decision-making processes on the use of rehabilitation technology (RT) in clinical treatment.MethodsWe used a phenomenological qualitative approach, in which three OTs and two PTs employed at a major, technology-encouraging rehabilitation hospital wrote vignettes from a written prompt describing their RT use decisions during treatment sessions with nine patients (4 with stroke, 2 traumatic brain injury, 1 spinal cord injury, 1 with multiple sclerosis). We then coded the vignettes using deductive qualitative analysis from 17 constructs derived from the RT literature and the Consolidated Framework for Implementation Research (CFIR). Data were synthesized using summative content analysis.ResultsOf the constructs recorded, the five most prominent are from CFIR determinants of: (i) relative advantage, (ii) personal attributes of the patients, (iii) clinician knowledge and beliefs of the device/intervention, (iv) complexity of the devices including time and setup, and (v) organizational readiness to implement. Therapists characterized candidate RT as having a relative disadvantage compared to conventional treatment due to lack of relevance to functional training. RT design also often failed to consider the multi-faceted personal attributes of the patients, including diagnoses, goals, and physical and cognitive limitations. Clinicians’ comfort with RT was increased by their previous training but was decreased by the perceived complexity of RT. Finally, therapists have limited time to gather, setup, and use RT.ConclusionsDespite decades of design work aimed at creating clinically useful RT, many lack compatibility with clinical translation needs in inpatient neurologic rehabilitation. New RT continue to impede the immediacy, versatility, and functionality of hands-on therapy mediated treatment with simple everyday objects.

Purpose The aim of this study was to investigate clinicians’ perspectives regarding their usage of rehabilitation technology in their day-to-day practice and uncover the factors that impact clinicians’ use of rehabilitation technology in their daily practice. Materials and methods An online survey was used to gather cross-sectional data from American occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and speech language pathologists. This survey used Likert-scale, multiple choice, and free-response questions. Results Approximately half (n = 56/105, 53.3%) of our clinicians reported using rehabilitation in their daily practice. Less than 20% (n = 18/105, 17.1%) of the respondents strongly agreed that they felt comfortable implementing new rehabilitation technology, and few reported that their workplace encouraged (n = 16/85, 18.8%) or strongly encouraged (n = 14/85, 16.5%) the use of rehabilitation technology in practice. Additionally, excluding the 2011–2020 graduate clinicians that reported that they had not learned about rehabilitation technology in school or fieldwork, few reported feeling prepared (n = 14/97, 14.4%) or very prepared (n = 4/97, 4.1%) to use rehabilitation technology after graduation. Conclusions Our findings have revealed a sizable knowledge-to-practice gap in regard to clinicians’ preparedness to engage with and advocate for rehabilitation technology in their day-to-day practice.

Purpose: Rehabilitation technology (RT) development has grown, however evidence suggests poor uptake by therapists and patients, with many devices abandoned. Successful implementation encompasses both “adoption,” where RT is first utilized, and “sustained use,” wherein RT remains in use over time. This scoping review and qualitative analysis aimed to explore the extent and nature of the relevant evidence base and investigate factors that influence adoption and sustained use of RT in clinical practice, from the perspectives of patients and therapists. Methods: A systematic search was conducted to identify qualitative and quantitative articles investigating adoption and/or sustained use of RT. Study characteristics were analyzed quantitatively. Factors influencing adoption and sustained use were analyzed using a two-stage thematic analysis. Stage 1 employed an inductive approach, analyzing data related to RT adoption from review papers. Stage 2 employed an abductive approach, where data related to sustained use from primary research and reviews was mapped to Stage 1 themes and new themes were identified. Results: The review included 42 articles. The majority of articles explored RT adoption. Thematic analysis revealed five themes. Four influenced adoption of RT: (1) “Knowledge” about RT; (2) “Design” of RT; (3) “Circumstances and Characteristics;” and, (4) the “Person-centered” approach. These were confirmed and refined in the sustained use analysis, and a fifth theme, “Healthcare Ecosystem,” was identified. Conclusion: These findings highlight factors influencing adoption and sustained use of RT, providing insights for development and implementation of technology in rehabilitation clinical practice. Further research is needed to identify strategies that facilitate sustained use of RT.

Purpose There is limited information on rehabilitation technology and its ability to support hospitalised older adults. This review aims to examine the extent and types of rehabilitation technology used for hospitalised older adults, assess technology readiness levels (TRLs), identify outcome variables and evaluate the level of evidence. Materials and methods A scoping review was conducted across six electronic databases (Medline, PsycInfo, EMBASE, CINAHL, Web of Science and Scopus) to evaluate studies investigating the use of rehabilitation technology among hospitalised older adults, in accordance with PRISMA-ScR guidelines. Results The search yielded 5310 records, with 23 meeting inclusion criteria and included for final analysis. Robotics were the most common rehabilitation technology, in six studies, followed by games in five studies, virtual reality in four studies and mobile applications in three studies. Rehabilitation technology mainly addressed functional mobility and physical performance, and functional independence and activities of daily living. Although the median TRL was high, with 8 studies achieving Level 1b evidence quality, variability in outcome measures, participants and intervention protocols limits the strength of available evidence. Conclusion Rehabilitation technologies show promise for supporting hospitalised older adults; however, more research is needed to determine feasibility, cost-effectiveness and implementation in clinical practice.

Osteoarthritis (OA), a common disease in the aged, may cause the structural integrity of joints to gradually decline, indicating that OA affects 10–20% of the elderly population. Clinical symptoms of OA in the knee joints, such as joint stiffness, discomfort, and functional deficits, may harm the quality of life (QoL) of people with OA. Among those having knee OA, rehabilitation technology can improve their QoL and functional outcomes. This review aimed to identify different types of rehabilitation technology and assess their effectiveness in enhancing functional outcomes for individuals with OA in the knee. A literature search was conducted from PubMed, Scopus, and Embase Data Base from December 2020 to December 2025. The search utilised terms such as “rehabilitation technology”, “machine learning”, “knee osteoarthritis”, “patellofemoral arthritis”, and “tibiofemoral arthritis”, employing Boolean operators (AND, OR). Related review articles, systematic reviews, conference papers, and articles in languages other than English were excluded. Two hundred thirty-nine articles were found from three databases, out of which only five met the inclusion criteria. These studies suggest that rehabilitation technology (virtual reality, wearable sensors, tele rehabilitation platforms) effectively and significantly improves functional outcomes. The findings suggest that patients with knee OA may find rehabilitation technology helpful in improving functional outcomes. The included research quality varied, and several had methodological problems despite the encouraging data.

Extended reality (XR) and telerehabilitation (TR) technologies are increasingly being used into stroke rehabilitation. These technologies have the potential to enhance therapy intensity, motivate users through engaging and interactive environments, and improve access to rehabilitation services in both clinical and home settings. Usability assessment is essential to ensure effective, engaging, and accessible interventions. This scoping review aims to identify tools used to evaluate XR and TR technologies in stroke rehabilitation. This scoping review was conducted following the methodological framework of Arksey and O'Malley, further refined by Levac et al. and the Joanna Briggs Institute. A literature search was performed across five databases (MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science) using keywords and their variations related to stroke, virtual reality, augmented reality, mixed reality, telerehabilitation, and usability evaluation. Peer-reviewed articles and conference abstracts published up to December 2024 were included if they reported on the usability evaluation of XR or TR technologies in neurological rehabilitation. Two reviewers independently screened studies for eligibility. Relevant data were extracted using a standardized data charting framework. The search yielded 2,290 articles, of which 111 were included in the review. Twenty-eight tools were identified, encompassing both direct usability assessments and complementary tools addressing related aspects. These tools were grouped into six categories: (1) standardized questionnaires, (2) custom questionnaires, (3) semi-structured interviews, (4) task-based usability testing, (5) modified standardized questionnaires, and (6) think-aloud protocols. The most frequently used tool was the System Usability Scale (SUS), followed by custom questionnaires. Among studies explicitly evaluating usability, 55.9% combined two to six tools to capture multiple facets of usability. Usability was assessed in 67.6% of publications using quantitative methods (e.g., questionnaires), in 4.5% using qualitative methods (e.g., interviews, focus groups), and in 27.9% using mixed methods approaches. Usability of XR and TR technologies is assessed with a wide variety of tools. Combining tools helps capture different aspects of usability, highlighting the importance of addressing its multifaceted nature in stroke rehabilitation. Future research could develop and validate a framework integrating multiple aspects of usability to ensure both relevance and comparability across studies.

Recovery of severe impairment as a result of acquired brain injury from conditions such as stroke and trauma can be limited. However, with neuroplasticity and re-learning of lost skills, the impairment can be overcome or reduced. The use of technology in rehabilitation has become synonymous in most advanced rehabilitation facilities. The outcome of chronic impairment is dependent on the rehabilitation approaches and new ways to address conventional strategies using technology. Technology in rehabilitation is an exciting avenue for research. The use of 3-Dimensional Virtual Reality (3-D VR) in gaming has escalated in the past few years. However, the therapeutic use of 3-D VR in rehabilitation medicine is still lagging, although small studies have shown some potential on its use. We, at Faculty of Medicine UiTM embarked on a study to create a platform for 3-D VR application, (MRVR: Medical Rehabilitation Virtual Reality) with known neuroplastic strategies for individuals with acquired brain injury during rehabilitation. Outcome measures used will be that of standard and validated parameters before and after the application of MRVR. Specific aspects of rehabilita t ion parameters were addressed during the programme development. A low cost commercial 3-D VR system was chosen (HTC VIVE™) to be used for the MRVR and our team developed a number of therapeutic programmes. Individuals with brain injury undergo a sequence of immersive first person experience with the MRVR programme in a safe virtual environme nt. The MRVR also promote recovery through other theories of rehabilitation such as, enriched environment, imagery, increased engagement and participation, accessibility and gamificat ion. We hypothesize that individuals that uses MRVR will have improved outcome parameters post intervention. These findings will assist in changing the standards for neurorehabilitation, by improving functional outcome, productivity, quality of life and overall longevity of individuals with disability. This study is funded by UiTM Research Grant: 600-IRMI/DANA 5/3 BESTARI (057/2017)International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 11

Chronic conditions such as stroke, Parkinson's disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care-i.e., exoskeletons, virtual/augmented reality, and remote monitoring-offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption.

Myotonic Dystrophy type 1 (DM1) is a slowly progressive hereditary neuromuscular disorder affecting several organ systems including the musculoskeletal system. To examine the effects of rehabilitation technology on arm and hand function in the assessment and treatment of adults with DM1 with moderate to severe muscle impairment. A single subject experimental design study (SSED) with 6 participants. The assessments were done weekly through remote study assessments using the video-conference system Whereby®. Participants performed the nine-hole peg test (NHPT), active range of motion (AROM) of the shoulder and patient reported outcome measures (PROMS). Three participants also measured grip and pinch strength and performed the Nut and Bolt task. The intervention was a three-week in-patient rehabilitation stay with the use of rehabilitation technology for exercising arm and hand function. Exercises were performed in AMADEO and the ArmeoSenso. The participants exercised the upper extremities for 30 min 5 times a week. Improvement on the NHPT test on the dominant hand were found for five of the six participants. Three of six improved on the non-dominant hand and in AROM. Two of the three participants that measured pinch and grip strength improved, and all three improved on the Nut and Bolt task. Self- reported function, myotonia and fatigue remained stable. All participants were able to participate in video assessments. Impairment in arm- and hand function affects independence in people with DM1.Our findings suggest that exercising arm- and hand using rehabilitation technology may have a positive effect on function measured by dexterity, strength, and movement in DM1. There is a need to study the effect of exercise on arm- and hand function in DM1 in larger studies. The use of video-consultations can be a supplement in assessment of people with neuromuscular conditions in research and clinical practise.

Purpose To explore specialist amputee physiotherapists’ experiences and subsequent views about specialist inpatient rehabilitation (IPR) as a National Health Service (NHS) pathway option for adult primary amputees and their perceptions and beliefs about the effects of inpatient amputee rehabilitation. Materials and methods A qualitative study using a phenomenological approach. Semi-structured interviews were completed with seven physiotherapists experienced in working in both specialist amputee inpatient and outpatient rehabilitation settings. Interviews were audio-recorded and fully transcribed. Data were analysed using thematic analyses; inductive coding was completed; emerging themes are shown and a conceptual framework was developed. To promote rigour, this study was peer reviewed and coding was done by two people. Results Clinicians believed inpatient amputee rehabilitation to be the preferred model of rehabilitation for the majority of adult primary amputees. A central theme of healthcare inequality within primary amputee rehabilitation provision emerged with four sub-themes: IPR, outpatient rehabilitation, barriers, the ideal world. Geographical variation was described in: type of rehabilitation provided, timescales of prosthetic rehabilitation provision, fitting a prosthesis with wounds, and the availability of community rehabilitation services. Conclusions Healthcare inequality is a central concern identified by clinicians who work within amputee rehabilitation in the UK. Clinicians interviewed believe NHS specialist amputee inpatient rehabilitation should be a more accessible pathway. Implications for rehabilitation Clinicians believe healthcare inequality exists within primary amputee rehabilitation provision in the UK National Health Service (NHS). Geographical variation in type of care provision, fitting a prosthesis with wounds, timescales in prosthetic rehabilitation provision and community rehabilitation services were described. Clinicians believe inpatient amputee rehabilitation to be the preferred model of care for the majority of adult primary amputees and should be a more accessible pathway within the NHS. Inpatient rehabilitation facilities may be a way of compensating for amputee rehabilitation inequalities.

Purpose Stroke survivors often report unmet rehabilitation needs. Digital care has become increasingly prevalent, but limited research has explored its role in stroke rehabilitation, particularly from perspectives of people with chronic stroke. This study aims to explore how people with stroke perceive the usage of digital technologies in post-stroke rehabilitation. Methods A qualitative study was conducted from June 2022 to January 2023, encompassing semi-structured interviews with 17 stroke participants recruited from a Norwegian rehabilitation hospital. Reflexive thematic analysis was applied. Results Two themes were generated 1) “Still digitally connected” Digitalisation and its impact on everyday life and rehabilitation services, and 2) “To bring people closer” The need for personal contact and responsibility in digital rehabilitation services. Participants continued using digital technologies in rehabilitation and recognised digital self-management tools as beneficial for exercising and gaining information in the stroke process. They used various technologies to stay connected to the rehabilitation network, such as video-consultations, apps and exergaming. Conclusions This study highlights the importance of digital tools in managing the individuals’ rehabilitation post-stroke. Digital technologies have the potential to deliver an interactive and person-centred rehabilitation service between healthcare professionals and people with stroke, but evaluation of technology use challenges after stroke is emphasised.

The prevalence of neurological disorders such as stroke, spinal cord injury and traumatic brain injury is increasing quickly in the industrialised societies. Although the benefit of the use of technology in rehabilitation and neurorehabilitation programs is proved, the presence of mechatronic systems is still very low. This paper proposes a new lower limb exoskeleton for functional rehabilitation in persons with neurological pathologies. Since potential users have very reduced mobility even to start common daily movements, the control of the exoskeleton has to be intention based The estimation of the intention of the user is based on hip and knee angle, and the EMG signal is monitored for intention detection, control and neurofeedback aims. A novel approach of a whole mechatronic system has been done in order to approach functional rehabilitation in patients with neurological disorders and stroke. The EMG to force conversion in paraplegic patients is also described.

Background: The comprehensive therapeutic program, Constraint-induced movement therapy (CIMT), focuses on functional training of the paretic upper limb and the transfer of acquired skills in daily life. Aim: The purpose of the survey was to map the current experience of therapists and patients with the therapeutic toolkit and home activity monitoring. Methods: The components of CIMT currently used, monitoring forms, barriers to provision, and motivations and subjectively perceived limitations for the use of technology in rehabilitation for activity monitoring were explored with the use of on-line surveys. Results: A total of 95 occupational therapists and physiotherapists and 91 patients participated in the survey. Czech therapists reported the most common perceived barriers that limit CIMT provision were as follows: low number of suitable patients, lack of knowledge of the method, increased administrative and time demands, or concerns about the high demands of the method for patients. The patients themselves are then limited in participating in the program due to its low accessibility or fear of the high difficulty of the exercise. As part of monitoring, patients complete a paper exercise diary (36%) or less frequently one on a computer (6.7%), but most often they do not track the results (40.4%). A total of 55% of patient respondents are motivated to share their results electronically with their therapist. Conclusions: According to the survey results, patients with spastic paresis of the upper limb after brain injury are motivated to participate in remote therapy and share results of home exercise remotely. The application of innovative approaches in CIMT and activity monitoring increases the availability of therapeutic interventions with potential cost reduction in clinical practice.