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Telemedicine services must be designed and implemented with the users in mind. When conducting telerehabilitation, factors such as age, education and technology experience must be taken into account. In addition, telerehabilitation must also accommodate a range of potential patient impairments, including deficits in language, cognition, motor funct...
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Context 1
... microergonomics, which considers only the users and their relationship with technology, macroergonomics is a top-down approach which considers the human - technology relationship relative to the organizational structure and external environment in which it occurs. 1 By focusing equal attention on the four subsystems ( personnel, technology, organization and environment) (Figure 1), valuable insight can be obtained into how telemedicine programmes operate and how they can be optimized. ...
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Citations
... Such technology triggered a strong interest in the adoption of these individuals in order to promote inclusion. Brennan and Barker's [34] article, cited 49 times, is the second most cited work in the cluster. The study developed and implemented telerehabilitation systems that meet the users' needs with varying abilities. ...
The digitalization of the world has rendered design for digital inclusion particularly important, which highlights the need to gain a comprehensive understanding of this field. The purpose of this review is to reveal the current development of the field of design for digital inclusion and identify research gaps and directions.Therefore, this study adopted bibliometric mapping to achieve the research goal. A total of 721 relevant articles in English were identified from Scopus. Descriptive analysis, including the publication trend, the most cited journals, the most cited articles, and the top authors with institutions, is described in order to trace the state-of-the-art development of the field. Network analysis, including bibliographic coupling and co-occurrence keywords, was used to identify research themes and future research directions. The results reveal four main investigated topics in the field: (1) information technology; (2) online education; (3) assistive technology; and (4) digital health. The review also highlights the distinctive features of design for digital inclusion compared to inclusive design, discusses the research gaps =, and offers potential future research directions.
... Digital physical therapy is a term that is being used in tandem with several other words such as tele-physiotherapy, e-physiotherapy, and others to refer to the application of information and communication technologies in the provision of physical therapy services to people remotely in their homes or other environments [1]. Such services include consultations, therapeutic intervention via live or prerecorded materials, monitoring of home programs, education, and group therapy for people with similar conditions [2]. It is an aspect of physical therapy that has been gaining tremendous growth in the last decade [3] and experienced an explosive increase in significance due to the global impact of the coronavirus disease 2019 and its subsequent affectation on daily living through mandatory social distancing and other protocols that were instituted to ensure safety [4]. ...
... Information and communications technology infrastructure is a prerequisite for digital healthcare implementation. Since ICTs are composite measures of Internet and mobile applications, ICT usage for digital health care must embrace not only mobile network coverage or mobile phone subscriptions but also Internet technologies and web applications [2,25]. Furthermore, the World Confederation of Physiotherapists [26] reported that successful and secure digital consultations depend on the integrity of the key technology platforms. ...
Background
The increasing demand for physical therapy services worldwide calls for innovations to be made to meet the challenges of service delivery. However, little is known about the knowledge, attitude, and practice (KAP) of digital physical therapy among Nigerian physiotherapists. Hence, this study aimed to evaluate the level of KAP of digital physical therapy among physiotherapists in Nigeria.
Methods
This cross-sectional study purposively recruited 150 Nigerian physiotherapists. Copies of modified and validated questionnaires on the KAP of digital physical therapy from a previous study were sent to registered and licensed physiotherapists via electronic survey to assess the KAP of digital physical therapy. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p < 0.05.
Results
The mean age of the respondents was 29.76 ± 6.95 years. Most participants (81.3%) have a knowledge level above average, while 18.7% have below average. Furthermore, most (76.0%) of the respondents had a positive attitude toward digital physical therapy. In addition, more than two-thirds, 69.3% uses digital physical therapy platforms for physical therapy practice. Knowledge, attitude, and practice were not significantly associated with sociodemographic characteristics ( p > 0.05). Furthermore, there was no significant association between knowledge, attitude, and practice ( p > 0.05).
Conclusion
Many Nigerian physiotherapists demonstrated adequate knowledge, positive attitude, and good practice of digital physical therapy. However, knowledge, attitude, and practice of digital physical therapy were not influenced by sociodemographic characteristics.
... Telerehabilitation (TR), alternatively called teletherapy, virtual care, or digital practice, is a subset of telehealth that provides rehabilitation services from evaluation to management and counseling over a distance through electronic means. 4 In the context of the pandemic, it can overcome not just the barriers of geographical and physical distancing, time, costs, and travel, 5 but also the anxiety about contracting COVID-19. TR, especially through video calls, was deemed by many physiatrists in the Philippines to be useful during and possibly beyond the pandemic, and physiotherapy was considered among the top TR services that could potentially be delivered effectively and safely. ...
... These three variables are affected by a multitude of factors, such as the PT's baseline TR knowledge, attitudes, and experiences. 4 In the different models and theories of user acceptance, age, gender, and experience are key moderators of acceptance. 7 The attitude constructs that are direct determinants of acceptance and usage behavior based on the Unified Theory of Acceptance and Use of Technology (UTAUT) domains are performance expectancy (PE), effort expectancy (EE), attitude toward behavior (ATT), facilitating conditions (FC), social influence (SI), and behavior influence (BI). ...
Background and Objective. Pre-pandemic, various healthcare settings were not used to seeing patients virtually. The unprecedented need to adopt virtual care during the COVID-19 pandemic may have caught physical therapists (PTs) unready for it. This study aimed to determine the telerehabilitation knowledge, attitude, and practice of PTs in the Philippines during the COVID-19 pandemic and determine the association between demographic and study outcome variables.
Methods. This is an analytical cross-sectional study among members of the Philippine Physical Therapy Association, Inc. (PPTA) practicing in the Philippines. Purposive sampling (total enumeration) was employed. All PPTA members were invited to the study through e-mail and official social media group chats. A self-administered questionnaire was used to obtain data on telerehabilitation knowledge (through test questions on various theoretical aspects), attitude, and practice.
Results. The questionnaire items had a content validity index of >0.80. The study yielded a 40% response rate.
Most respondents were practicing clinicians in urban-based, private rehabilitation centers. Approximately half had average telerehabilitation knowledge, while the majority had agreeable telerehabilitation attitudes across different constructs. Among the respondents, 15.9% used telerehabilitation pre-pandemic, while 64.8% used it during the pandemic. Hybrid (synchronous and asynchronous) telerehabilitation sessions usually lasted one hour per patient, mostly using Facebook Messenger.
Conclusion. Telerehabilitation was not widely practiced locally pre-pandemic, which may explain their average
telerehabilitation knowledge. The positive telerehabilitation attitudes may represent a small group of PTs favoring telerehabilitation, while information from the larger population remains unknown. Early adopters of telerehabilitation may help introduce virtual care to colleagues and guide them in developing relevant knowledge and skills amid and beyond the enduring COVID-19 crisis.
... Innovative teleoperative assistive social robots also enable remote occupational or physical therapy as well as cardiac or vocational rehabilitation which is then called telerehabilitation [69]. Telerehabilitation robots can be divided in unilateral and bilateral systems [48]. ...
Assistive social robots aim to facilitate outpatient-care including required safety critical measures. Accepting a robot to perform such measures, e.g., operate in close physical interaction for medical examinations, requires human trust towards the robot. Human-in-the-loop (HIL) applications where the robot is teleoperated by a human expert can help the person to accept even risky tasks performed by a robot. Therefore, the assistive humanoid GARMI was designed to enable HIL applications with varying autonomy. In this study, we use GARMI to understand which tasks in the framework of care may be accepted depending on human socio-demographics and user beliefs as well as the level of robot autonomy. Firstly, we seek to understand the general acceptance of GARMI using the Almere questionnaire. Secondly, we ask adults to rate their willingness to use several functionalities of GARMI. Lastly, we investigate the effect of the introduction method of GARMI on user acceptance. We assemble all relevant factors on acceptance to provide direction in the user-centered design process of assistive robots. The results of 166 participants show that alongside others, trust towards the robot and utilitarian variables such as perceived usefulness are the most influencing factors on the acceptance of GARMI and should be considered for the design of robotic semi-autonomous outpatient-services.
... Malgré la croissance rapide et cet intérêt grandissant des TIC dans le secteur de la santé avec l'apparition de la pandémie liée au SARS-CoV-2 (Coucke & Coucke, 2020), la recherche menée sur ce thème dans le cadre particulier des projets de conception de dispositifs numériques en e-santé dans les maladies chroniques (e.g., obésité, diabète, maladies respiratoires chroniques, maladies cardio-vasculaires, cancers) est encore peu explorée ( Schopp et al, 2004;Brennan & Barker, 2008;Dinesen et al., 2011;Tousignant et al., 2013;Joensson et al., 2019). ...
Ce travail doctoral par article traite des projets de conception de téléréhabilitation (TR) dans les maladies chroniques (MC) et plus particulièrement de la complexité et de la rigueur nécessaire dans la conception de la TR. La contribution majeure de la thèse concerne la proposition d’une nouvelle démarche scientifique actionnable, à partir des connaissances académiques croisées en Systèmes d’Information, en Marketing dans le secteur de la e-santé, permettant aux acteurs de terrain d’agir pour favoriser l’optimisation d’un projet de conception de TR. Concrètement, en identifiant ce qui a été évalué dans la TR puis en intégrant les parties prenantes et l’utilisateur patient, nous cherchions à savoir comment favoriser la réussite d’un projet de conception de TR. Pour ce faire, nous proposons tout d’abord d’avoir une vision d’ensemble des domaines et processus d’évaluation de la TR dans le contexte des MC. Dans le premier manuscrit, nous concluons sur des besoins de multidisciplinarité et d’exhaustivité dans l’évaluation de la TR et confirmons une faible attention portée sur la phase de conception de la TR. A ce titre, nous décidons alors d’approfondir le caractère complexe des projets de conception auquel sont confrontées les différentes parties prenantes. A l’aide d’une étude de cas sur un projet de conception d’un dispositif de téléréhabilitation auquel nous sommes engagés, nous présentons, dans le manuscrit 2 un exemple de défis rencontrés lorsque l’organisation est face à la persistance de paradoxe. Nous montrons que les différents acteurs inter-organisationnels, présents dans le projet de conception, font l’usage d’objets frontières quand le paradoxe, lié à la place du patient comme partie prenante dans la conception, persiste dans le temps. A l’issue d’une analyse approfondie des premiers résultats de cette étude de cas, nous identifions d’autres défis sur les projets dont sont confrontés les différentes parties prenantes. Nous exposons alors dans le manuscrit 3, la manière dont se construit la légitimité organisationnelle d’un projet de conception de TR, qui est une vision originale dans la compréhension d'un projet de conception TI. Nos données montrent notamment que la réparation de la légitimation se situe au niveau symbolique autour d’une partie prenante « dormante », le patient, créant ainsi une cohésion entre les acteurs du projet. Le quatrième manuscrit présente finalement un nouveau terrain de recherche, où le patient n’a pas été partie prenante dans la conception car celle-ci est mise en place dans une situation d’urgence sanitaire. Au sein d’un réseau de santé accompagnant des malades respiratoires chroniques, ce dernier travail de thèse, en cours d’élaboration, vise à présenter la façon dont le patient vit cette expérience de TR en post-implémentation. Notre attention est portée sur le parcours patient intégrant la TR avec un double objectif : d’une part, approfondir la compréhension de ce parcours en restituant l’« expérience » patient et, d’autre part, identifier l’impact sur le processus de conception d’un nouveau service de e-santé comme celui de la TR. La discussion de la thèse aborde les conditions de succès de la démarche scientifique interdisciplinaire, proposée par les travaux de cette thèse, le choix des situations sur laquelle elle s’applique et les perspectives de recherche qui en découlent.
... Designing a therapeutic program using telerehabilitation requires consulting the skills and needs of PSA in order to eliminate all potential barriers related to technology. [26,27] ...
... In addition, recently, the global epidemiological situation has generated interest in telemedicine, including telerehabilitation, often allowing the continuity of therapy [51][52][53]. Patients with PSA constitute a diverse population, therefore, when designing a therapeutic program using telerehabilitation, the skills and needs of patients should be consulted in order to eliminate all potential barriers related to technology [27]. ...
Aphasia is one of the most common clinical features of functional impairment after a stroke. Approximately 21–40% of stroke patients sustain permanent aphasia, which progressively worsens one’s quality of life and rehabilitation outcomes. Post-stroke aphasia treatment strategies include speech language therapies, cognitive neurorehabilitation, telerehabilitation, computer-based management, experimental pharmacotherapy, and physical medicine. This review focuses on current evidence of the effectiveness of impairment-based aphasia therapies and communication-based therapies (as well as the timing and optimal treatment intensities for these interventions). Moreover, we present specific interventions, such as constraint-induced aphasia therapy (CIAT) and melodic intonation therapy (MIT). Accumulated data suggest that using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) is safe and can be used to modulate cortical excitability. Therefore, we review clinical studies that present TMS and tDCS as (possible) promising therapies in speech and language recovery, stimulating neuroplasticity. Several drugs have been used in aphasia pharmacotherapy, but evidence from clinical studies suggest that only nootropic agents, donepezil and memantine, may improve the prognosis of aphasia. This article is an overview on the current state of knowledge related to post-stroke aphasia pharmacology, rehabilitation, and future trends.
... Involving all stakeholders is important, as they are critical to successfully implement a tele-CR program. Potential differences between the number and quality of health care provider visits delivered through tele-CR versus those delivered through conventional cardiac rehabilitation further emphasize the importance of addressing human factors in tele-CR design processes [47]. Ideally, users or prescribers of the tele-CR system should be involved throughout the process, using a participatory design model, and feedback should be elicited from the patients, their caretakers, health care professionals, and health care company specialists [48]. ...
Background
Cardiac rehabilitation programs, consisting of exercise training and disease management interventions, reduce morbidity and mortality after acute myocardial infarction.
Objective
In this pilot study, we aimed to developed and assess the feasibility of delivering a health watch–informed 12-week cardiac telerehabilitation program to acute myocardial infarction survivors who declined to participate in center-based cardiac rehabilitation.
Methods
We enrolled patients hospitalized after acute myocardial infarction at an academic medical center who were eligible for but declined to participate in center-based cardiac rehabilitation. Each participant underwent a baseline exercise stress test. Participants received a health watch, which monitored heart rate and physical activity, and a tablet computer with an app that displayed progress toward accomplishing weekly walking and exercise goals. Results were transmitted to a cardiac rehabilitation nurse via a secure connection. For 12 weeks, participants exercised at home and also participated in weekly phone counseling sessions with the nurse, who provided personalized cardiac rehabilitation solutions and standard cardiac rehabilitation education. We assessed usability of the system, adherence to weekly exercise and walking goals, counseling session attendance, and disease-specific quality of life.
Results
Of 18 participants (age: mean 59 years, SD 7) who completed the 12-week telerehabilitation program, 6 (33%) were women, and 6 (33%) had ST-elevation myocardial infarction. Participants wore the health watch for a median of 12.7 hours (IQR 11.1, 13.8) per day and completed a median of 86% of exercise goals. Participants, on average, walked 121 minutes per week (SD 175) and spent 189 minutes per week (SD 210) in their target exercise heart rate zone. Overall, participants found the system to be highly usable (System Usability Scale score: median 83, IQR 65, 100).
Conclusions
This pilot study established the feasibility of delivering cardiac telerehabilitation at home to acute myocardial infarction survivors via a health watch–based program and telephone counseling sessions. Usability and adherence to health watch use, exercise recommendations, and counseling sessions were high. Further studies are warranted to compare patient outcomes and health care resource utilization between center-based rehabilitation and telerehabilitation.
... Tele-rehabilitation is the delivery of rehabilitation services to patients remotely using tele-communication technologies (Schmeler et al., 2009). Rehabilitation includes various services such as speech therapy (Brennan & Barker, 2008) to treat stuttering disorder. This disorder can have a negative effect on the patient's daily life (Craig et al., 2009). ...
... The prevalence of stuttering is approximately one percent (Yairi & Ambrose, 2013). Increased demand for treatment and shortage of service providers are challenges in providing tele-rehabilitation services (Brennan & Barker, 2008). In this regard, video conferencing can overcome the barriers to access remote healthcare services and provide faster access to therapy interventions (Ciccia et al., 2011). ...
The purpose of this study was to investigate the benefits and challenges of the tele-speech therapy from the perspective of patients who stutter, and their parents. Semi-structured interviews were conducted with 12 patients and three parents in two rehabilitation centers. Data were analyzed using a qualitative content analysis approach proposed by Graneheim and Lundman. Seven categories were determined: accessible treatment, motivation of comfort in tele-speech therapy, challenges of tele-therapy, satisfaction, virtual competency, lower quality compared to face-to-face therapy, and uncertainty about the effectiveness of tele-speech therapy. The participants had a two-sided perspective regarding tele-speech therapy. Positive experiences included benefitting from more qualified therapists at multiple locations, faster access to treatment, and saving cost and time. Negative experiences and challenges consisted of low-quality of technology infrastructure for rehabilitation including low quality of shared images and videos, ineffective communication, insufficient sympathy, indirect communication, and technology incompetency. Findings showed that the participants were interested in the application of tele-speech therapy, as this method could increase their accessibility and provide the opportunity to choose proper therapists. The determined benefits and challenges can provide the policy-makers with beneficial information to implement tele-speech therapy.
... In addition, some of the respondents opined that difficulty in learning to use technology may have an impact on how and if a telerehabilitation will replace current clinical practice. This can be affirmed by the finding in the study by Brennan and Barker [26] which showed that the barrier to technology adoption reveals the learning curve for users on both the clinical and remote sides. Users must understand a technology or software and be able to independently adjust settings and maintain the technology. ...
Background and Objective
Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation.Methods
This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05.ResultsThe mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age (X2 = 7.119; p = 0.001).DiscussionThe responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation.Conclusion
Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use.
... Dla pacjenta jako beneficjenta programu (usługi) najważniejszą rolę odgrywa osoba, z którą ma bezpośredni kontakt. W gronie specjalistów zaangażowanych w telerehabilitację pacjentów z protezami słuchu wymienia się: lekarzy, techników, terapeutów (logopeda, psycholog), rehabilitantów oraz personel innych specjalności: techników komputerowych, administratorów stron, którzy pomagają w sprawnym działaniu usługi, ale nie pozostają w bezpośrednim kontakcie z pacjentem, lecz mogą, jeśli potrzeba -ze specjalistą [15]. David Brennan i Linsey Barker, powołując się na stanowisko prezentowane przez American Speech-Language-Hearing Association and the Canadian Association of Occupational Therapists, wskazują potrzebę właściwego doboru personelu, zwłaszcza uprawnionego do bezpośredniego kontaktu z pacjentem, który powinien cechować profesjonalizm, posiadanie stosownych uprawnień, wykształcenie, właściwe podejście, doświadczenie w pracy z osobami niedosłyszącymi lub niesłyszącymi oraz znajomość obsługi urządzeń i/lub aplikacji wykorzystywanych podczas usług [15]. ...
... W gronie specjalistów zaangażowanych w telerehabilitację pacjentów z protezami słuchu wymienia się: lekarzy, techników, terapeutów (logopeda, psycholog), rehabilitantów oraz personel innych specjalności: techników komputerowych, administratorów stron, którzy pomagają w sprawnym działaniu usługi, ale nie pozostają w bezpośrednim kontakcie z pacjentem, lecz mogą, jeśli potrzeba -ze specjalistą [15]. David Brennan i Linsey Barker, powołując się na stanowisko prezentowane przez American Speech-Language-Hearing Association and the Canadian Association of Occupational Therapists, wskazują potrzebę właściwego doboru personelu, zwłaszcza uprawnionego do bezpośredniego kontaktu z pacjentem, który powinien cechować profesjonalizm, posiadanie stosownych uprawnień, wykształcenie, właściwe podejście, doświadczenie w pracy z osobami niedosłyszącymi lub niesłyszącymi oraz znajomość obsługi urządzeń i/lub aplikacji wykorzystywanych podczas usług [15]. W znaczącej większości przypadków specjaliści zaangażowani w bezpośredni kontakt z pacjentami pracują w ośrodkach, które świadczą usługi rehabilitacyjne w systemie stacjonarnym i jednocześnie realizują zadania telerehabilitacji, np. ...
... Zauważali oni, że potrzeby pacjentów jako odbiorców telepomocy implikują konieczność modernizacji technik stosowanych w bezpośredniej współpracy. Fizyczna nieobecność specjalisty (zwłaszcza w modelach asynchronicznych) zachowuje element, jakim jest "czynnik ludzki", jak i nie zmniejsza efektywności usług świadczonych w systemie telezdrowia [15]. Specjaliści prowadzący trening dotyczący problemów artykulacyjnych, jakości mowy, terapii głosu zgłaszali, że jakość przekazu ma duże znaczenie przy wysłuchiwaniu wypowiedzi pacjenta (np. ...
Telemedycyna to najnowsza forma opieki zdrowotnej, łącząca w sobie elementy telekomunikacji, informatyki oraz medycyny. Osiągnięcia techniczne w połączeniu z doświadczeniem specjalistów implikują powstawanie programów opieki nad pacjentami w różnym wieku i z różnego typu problemami zdrowotnymi realizowanych „na odległość”. Telerehabilitacja umożliwia dostarczenie odbiorcy usług rehabilitacyjnych z wykorzystaniem sieci połączeń telekomunikacyjnych i Internetu. W odniesieniu do osób z wadą słuchu, w tym korzystających z tradycyjnych aparatów słuchowych i/lub implantów słuchowych, działania o charakterze rehabilitacyjnym wpisują się także w programy określane mianem teleaudiologii i telezdrowia. W artykule przedstawiono najważniejsze doniesienia z literatury (artykułów, prac doktorskich, doniesień wstępnych, streszczeń i prezentacji) oraz raportów z realizacji programów unijnych, które podsumowują badania i działania praktyczne skierowane do pacjentów dorosłych korzystających z protez słuchowych w ramach szeroko rozumianej telerehabilitacji. Przedstawione zostały modele postępowania, prowadzący i odbiorcy programów, formy świadczenia usług oraz wrażenia uczestników terapii organizowanych w systemie „tele”. Wykorzystanie technologii w przygotowaniu i prowadzeniu opieki nad osobami z wadą słuchu stanowi istotną pomoc zwłaszcza w rejonach, gdzie brak specjalistów lub ograniczony dostęp do nich determinuje skuteczność stosowania określonego postępowania medycznego.
