A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs

Abstract

Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.

Gait Assessment Using Smartphone Applications in Older Adults: A Scoping Review

“…In this context, quantifying the re-establishment of function is essential in the success of therapy, and this technology can be used to measure and monitor movements in order to support clinical decision-making [ 40 , 41 ]. Smartphones and mobile apps enable the objective and responsive assessment of physical function during functional tests, gait training or exercise programs, and the increasing use of smartphone technology in our daily lives and clinical settings will simplify patient assessment, therapy and follow-ups for health professionals [ 42 ]. Smartphones provide a cheap and accessible means of efficiently collecting large amounts of human gait data in an unconstrained environment compared to motion capture systems, electromyography or other systems that require costly equipment and trained engineers, which are only available in movement analysis research laboratories.…”

Recent Advances in Wearable Healthcare Devices: From Material to Application

“…Some sensors focus on gait analysis for fracture healing. Wearable sensors can continuously monitor the gait status and reach the healing process [133,134]. They can also be applied to some diseases, such as Parkinson's disease [135].…”

A Systematic Review of the Effects of Interactive Telerehabilitation with Remote Monitoring and Guidance on Balance and Gait Performance in Older Adults and Individuals with Neurological Conditions

“…Over the past decade, the most commonly used methods are VR [17], training and learning apps [42], gamification [43], and videoconferencing [19]. In total, 6 of the 17 studies used VR for interactive telerehabilitation [26,31,34,36,38,39], and 5 of those 6 incorporated an off-the-shelf platform or a miniaturized motion sensor, such as Microsoft Kinect [26,36,39] and inertial sensors [31,38].…”