Emerging Technologies in Rehabilitation for Complex Injuries and Conditions

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Top Contributors - Wanda van Niekerk and Jess Bell  

Importance of Innovative Technology in Rehabilitation[edit | edit source]

Innovative technology has grown substantially in the rehabilitation setting. Rehabilitation professionals are often involved with the testing, development and modification of new and existing technology, alongside engineers and development teams. These innovations can improve rehabilitation, prevent decline and regression, monitor changes and help with maintaining healthy living. This ultimately strives to improve the quality of life for complex injuries and conditions.[1]

Innovative technology has the ability to:

  • enhance the treatment and management of complex injuries and conditions
  • make rehabilitation more effective, efficient and patient-centred
  • reduce environmental barriers[1]
    • for example smart home devices can perform tasks with little human input
    • innovative equipment can help decrease the impact of impairments on activity and participation
  • connect people with one another and provide support to each other in real-time
    • for example social media and internet support groups for people with similar injuries and conditions[1]

For the use of innovative technology to be effective in patients with complex injuries and conditions, rehabilitation professionals need to stay up to date with the latest emerging technologies so that they can provide the best possible care to their patients.

Emerging Technologies in Rehabilitation[edit | edit source]

Telerehabilitation[edit | edit source]

Telerehabilitation refers to the delivery of rehabilitation services by any rehabilitation professional through digital (information and communication technologies) mode.[2][3] With the advances in communication technology, telerehabilitation has now become a viable option for delivery of rehabilitation services. It's use and effectiveness have been tested in various complex injuries and conditions such as:

Complex Injury/Condition Telerehabilitation Research
Stroke
  • Low or moderate quality evidence were reported and findings suggest that telerehabilitation may not be inferior to in-person therapy and may therefore be a relevant model of service delivery to patients that need rehabilitation after stroke.[4]
  • Telerehabilitation is reported as a feasible and alternative method to conventional treatment or as complimentary treatment to improve treatment outcomes. Telerehabilitation has been shown to have good outcomes on motor and cognitive functions, aphasia and speech-linguistics in patients recovering from stroke. It may have positive effects on patient engagement and motivation.[5]
  • Telerehabilitation was found to be effective on patient satisfaction and clinical parameters such as hand function and balance in patients recovering from stroke.[6]
Multiple sclerosis
  • Telerehabilitation is reported to improve general quality of life, muscle strength and endurance in people with multiple sclerosis[6]and may beneficial for the treatment of motor systems in people with multiple sclerosis[7]
Parkinson's disease
  • Telerehabilitation may help improve balance and function[6]and maintain or improve gait, speech and voice, quality of life and patient satisfaction in people Parkinson's disease.[8]
Spinal cord injuries
  • Telerehabilitation in the context of spinal cord injuries is referred to as teleSCI.[9] Recent research trends on teleSCI include preventive health and wellness after SCI, chronic pain management, anxiety and depression, restorative and rehabilitation care and disaster planning.[9] The benefits of teleSCI modalities are increased adherence and lower attrition rates which may improve clinical outcomes.[9]
Traumatic brain injury
  • Evidence is still lacking on telerehabilitation in people with traumatic brain injury, but it may be a useful tool to facilitate and ensure continuity of care between hospital discharge and return to home.[10]
  • Read more: Telerehabilitation in Acquired Brain Injury[11]
Cardiopulmonary
  • Cardiopulmonary telerehabilitation is a safe and convenient alternative to in-person rehabilitation programmes. It improves patient participation by reducing barriers such as logistics (transport) and finances. It includes remote monitoring, health coaching, patient education and social engagement which may facilitate and improve patients' interest, participation and motivation.[12]
Musculoskeletal disorders
  • Telerehabilitation may improve health outcomes in people with musculoskeletal disorders.[13] It can improve patient engagement and provide efficient patient education opportunities. It has also been shown to be similar to in-person treatment in the reduction of pain and the improvement of function and quality of life.[14]
Burn injuries
  • Home-based telerehabilitation has been shown to be a safe and effective option for exercise program delivery for patients with burn injuries ≤ 25% TBSA (total body surface area). Further research is required in patients with burn injuries and telerehabilitation.[15]
Post-operative rehabilitation
  • Telerehabilitation is feasible and effective in surgical patients compared to usual care. Patients' showed an improved quality of life, but further research is recommended.[16]
Limb loss
  • Persons with amputation have specific and unique needs. This must be taken into consideration when providing telerehabilitation services. Ideally, the rehabilitation process should involve a collaborative interdisciplinary team, so telerehabilitation should be a team approach for persons with amputation. The use of prosthetic limbs makes the provision of telerehabilitation services more complex. Special precautions may be necessary with virtual gait retraining if the person is new to wearing a prosthesis or where balance and coordination may be an issue.[17]

Benefits and Challenges of Telerehabilitation[edit | edit source]

Table 2. Benefits and Challenges of Telerehabilitation in Patients with Complex Injuries and Conditions
Benefits Challenges
increased access to care access to technology[18]
reduced travel burden privacy concerns[18]
time-saving aspect with regards to travel time to clinic but also taking time off from work to attend in-person appointments[17] training for proper use and implementation (both patient and rehabilitation professional)[18]
quicker/expedited access to care[17]
provides opportunities for rehabilitation professionals to assess a person's needs within their home[17]

Virtual Reality Therapy[edit | edit source]

Virtual reality therapy uses immersive computer-generated environments that simulates real-life scenarios through visual and auditory channels for rehabilitation purposes.[19]

Sub Heading 3[edit | edit source]

Resources[edit | edit source]

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References[edit | edit source]

  1. 1.0 1.1 1.2 Winstein C, Requejo P. Innovative technologies for rehabilitation and health promotion: what is the evidence?. Physical therapy. 2015 Mar 1;95(3):294-8.
  2. Giesbrecht E, Major ME, Fricke M, Wener P, van Egmond M, Aarden JJ, Brown CL, Pol M, van der Schaaf M. Telerehabilitation delivery in Canada and the Netherlands: results of a survey study. JMIR Rehabilitation and Assistive Technologies. 2023 Feb 20;10(1):e45448.
  3. Brennan D, Tindall L, Theodoros D, Brown J, Campbell M, Christiana D, Smith D, Cason J, Lee A. A blueprint for telerehabilitation guidelines. International journal of telerehabilitation. 2010;2(2):31.
  4. Laver KE, Adey‐Wakeling Z, Crotty M, Lannin NA, George S, Sherrington C. Telerehabilitation services for stroke. Cochrane Database of Systematic Reviews. 2020(1).
  5. Nikolaev VA, Nikolaev AA. Recent trends in telerehabilitation of stroke patients: A narrative review. NeuroRehabilitation. 2022 Jan 1;51(1):1-22.
  6. 6.0 6.1 6.2 Özden F, Özkeskin M, Ak SM. Physical exercise intervention via telerehabilitation in patients with neurological disorders: A narrative literature review. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2022 Feb 19;58(1):26.
  7. Di Tella S, Pagliari C, Blasi V, Mendozzi L, Rovaris M, Baglio F. Integrated telerehabilitation approach in multiple sclerosis: a systematic review and meta-analysis. Journal of telemedicine and telecare. 2020 Aug;26(7-8):385-99.
  8. Vellata C, Belli S, Balsamo F, Giordano A, Colombo R, Maggioni G. Effectiveness of telerehabilitation on motor impairments, non-motor symptoms and compliance in patients with Parkinson's disease: a systematic review. Frontiers in Neurology. 2021 Aug 26;12:627999.
  9. 9.0 9.1 9.2 Touchett H, Apodaca C, Siddiqui S, Huang D, Helmer DA, Lindsay JA, Ramaswamy P, Marchant-Miros K, Skelton F. Current approaches in telehealth and telerehabilitation for spinal cord injury (TeleSCI). Current Physical Medicine and Rehabilitation Reports. 2022 Jun;10(2):77-88.
  10. Bonanno M, De Luca R, De Nunzio AM, Quartarone A, Calabrò RS. Innovative technologies in the neurorehabilitation of traumatic brain injury: a systematic review. Brain sciences. 2022 Dec 7;12(12):1678.
  11. Subbarao BS, Stokke J, Martin SJ. Telerehabilitation in acquired brain injury. Physical Medicine and Rehabilitation Clinics. 2021 May 1;32(2):223-38.
  12. Aragaki D, Luo J, Weiner E, Zhang G, Darvish B. Cardiopulmonary telerehabilitation. Physical Medicine and Rehabilitation Clinics. 2021 May 1;32(2):263-76.
  13. Baroni MP, Jacob MF, Rios WR, Fandim JV, Fernandes LG, Chaves PI, Fioratti I, Saragiotto BT. The state of the art in telerehabilitation for musculoskeletal conditions. Archives of Physiotherapy. 2023 Jan 4;13(1):1.
  14. Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical rehabilitation. 2017 May;31(5):625-38.
  15. Plaza A, Paratz J, Cottrell M. A six-week physical therapy exercise program delivered via home-based telerehabilitation is comparable to in-person programs for patients with burn injuries: a randomized, controlled, non-inferiority clinical pilot trial. Burns. 2023 Feb 1;49(1):55-67.
  16. Van Egmond MA, Van Der Schaaf M, Vredeveld T, Vollenbroek-Hutten MM, van Berge Henegouwen MI, Klinkenbijl JH, Engelbert RH. Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy. 2018 Sep 1;104(3):277-98.
  17. 17.0 17.1 17.2 17.3 Webster J, Young P, Kiecker J. Telerehabilitation for amputee care. Physical Medicine and Rehabilitation Clinics. 2021 May 1;32(2):253-62.
  18. 18.0 18.1 18.2 Scholten J, Poorman C, Culver L, Webster JB. Department of veterans affairs polytrauma telerehabilitation: twenty-first century care. Physical Medicine and Rehabilitation Clinics. 2019 Feb 1;30(1):207-15.
  19. Rutkowski S, Kiper P, Cacciante L, Mazurek J, Turolla A. Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis. Journal of Rehabilitation Medicine. 2020 Nov 19;52(11):1-6.