Use, and acceptability, of digital health technologies in musculoskeletal physical therapy: A survey of physical therapists and patients

Application of digital technology in rehabilitation of total knee arthroplasty: A systematic review

Purpose

Total Knee Arthroplasty (TKA) aids in reducing pain and improving knee mobility, function, and quality of life in osteoarthritis knee (OA Knee). Techology-based rehabiliation has proved to be promising post-TKA. The objective of this systematic review was to summarize the digital technology after TKA.

Methods

The PRISMA Checklist was used for the present systematic review. Randomized and non-randomized studies were included. Joanna Briggs Critical Appraisal Checklist was used to assess risk of bias by two independent reviewers. The data was summarized narratively for the digital technologies utilized.

Results

177 studies were screened from the databases, and 14 studies were included. The risk of bias assessment showed low to moderate-quality evidence. The technologies were divided into 2 broad categories-mobile-based and web-based- although the individual studies had unique technologies utilizing sensors, motion trackers, and game-based and video-based.

Conclusion

Various digital technologies focus on providing exercise intervention post-TKA. Clinicians can use face-to-face and technology-based approaches for TKA rehabilitation for a comprehensive subjective and objective assessment post-TKA based on low to moderate quality studies.

eHealth interventions to support self-management: Perceptions and experiences of people with musculoskeletal disorders and physiotherapists - 'eHealth: It's TIME': A qualitative study

BACKGROUND

There is increasing interest in the potential role of eHealth interventions to support self-management in people with musculoskeletal disorders (MSDs). The COVID-19 pandemic appears to have been a significant catalyst for the implementation of eHealth modalities into routine practice, providing a unique opportunity for real-world evaluation of this underutilized method of delivering physiotherapy.

OBJECTIVE

To explore the perceptions of eHealth-mediated supported self-management from the perspective of people with MSDs and physiotherapists who work in this clinical area.

METHODS

A qualitative interpretive descriptive approach was used. Semi-structured telephone interviews with 13 musculoskeletal physiotherapists and 13 people with musculoskeletal disorders were undertaken. Transcripts were analyzed using reflexive thematic analysis.

RESULTS

Three main themes were identified: 1) Flexibility within a blended care model; 2) eHealth as a facilitator of self-management support; and 3) Technology: Getting it right. Participants expressed concerns about assessment and diagnosis, establishing a therapeutic relationship and felt eHealth should be reserved for follow-up purposes. There was a consistent view expressed that eHealth could facilitate aspects of self-management support. A lack of resources and suboptimal user experience remains a challenge.

CONCLUSIONS

eHealth-mediated self-management support interventions were broadly acceptably, predominately as a follow-up option.

Evaluation of Patient-Facing Mobile Apps to Support Physiotherapy Care: Systematic Review

BACKGROUND

Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by physiotherapists. A benefit of using apps is their ability to incorporate behavior change techniques (BCTs) that can optimize the effectiveness of physiotherapeutic interventions. Research continues to suggest that despite their importance, behavior change strategies are often missing in patient management. Evaluating mobile apps that physiotherapists can use to drive behavior change may inform clinical practice and potentially improve patient outcomes. Examining the quality of apps and exploring their key features that can support behavior change and physiotherapy care are important aspects of such an evaluation.

OBJECTIVE

The primary aim of this study was to describe the range of mobile apps in app stores that are intended for use by patients to support physiotherapy care. The secondary aims were to assess app quality, BCTs, and their behavior change potential.

METHODS

A systematic review of mobile apps in app stores was undertaken. The Apple App Store and Google Play were searched using a 2-step search strategy, using terms relevant to the physiotherapy discipline. Strict inclusion and exclusion criteria were applied: apps had to be intended for use by patients and be self-contained (or stand-alone) without the requirement to be used in conjunction with a partner wearable device or another plugin. Included apps were coded for BCTs using the Behavior Change Technique Taxonomy version 1. App quality was assessed using the Mobile App Rating Scale, and the App Behavior Change Scale was used to assess the app's potential to change behavior.

RESULTS

In total, 1240 apps were screened, and 35 were included. Of these 35 apps, 22 (63%) were available on both the Apple App Store and Google Play platforms. In total, 24 (69%) were general in their focus (eg, not condition-specific), with the remaining 11 (31%) being more specific (eg, knee rehabilitation and pelvic floor training). The mean app quality score (Mobile App Rating Scale) was 3.7 (SD 0.4) of 5 (range 2.8-4.5). The mean number of BCTs identified per app was 8.5 (SD 3.6). BCTs most frequently included in the apps were instruction on how to perform a behavior (n=32), action planning (n=30), and self-monitoring of behavior (n=28). The mean behavior change potential score (App Behavior Change Scale) was 8.5 (SD 3.1) of 21 (range 3-15).

CONCLUSIONS

Mobile apps available to support patient care received from a physiotherapist are of variable quality. Although they contain some BCTs, the potential for behavior change varied widely across apps.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/29047.

Are physiotherapists expected to be competent in digital health practice? Meta-synthesis of international physiotherapy practice competency standards

BACKGROUND

Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging.

OBJECTIVE

Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice.

METHODS

Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes.

RESULTS

Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities.

CONCLUSIONS

Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.

The Role and Importance of Using Sensor-Based Devices in Medical Rehabilitation: A Literature Review on the New Therapeutic Approaches

Due to the growth of sensor technology, more affordable integrated circuits, and connectivity technologies, the usage of wearable equipment and sensing devices for monitoring physical activities, whether for wellness, sports monitoring, or medical rehabilitation, has exploded. The current literature review was performed between October 2022 and February 2023 using PubMed, Web of Science, and Scopus in accordance with P.R.I.S.M.A. criteria. The screening phase resulted in the exclusion of 69 articles that did not fit the themes developed in all subchapters of the study, 41 articles that dealt exclusively with rehabilitation and orthopaedics, 28 articles whose abstracts were not visible, and 10 articles that dealt exclusively with other sensor-based devices and not medical ones; the inclusion phase resulted in the inclusion of 111 articles. Patients who utilise sensor-based devices have several advantages due to rehabilitating a missing component, which marks the accomplishment of a fundamental goal within the rehabilitation program. As technology moves faster and faster forward, the field of medical rehabilitation has to adapt to the time we live in by using technology and intelligent devices. This means changing every part of rehabilitation and finding the most valuable and helpful gadgets that can be used to regain lost functions, keep people healthy, or prevent diseases.