Integrating Tactile Feedback Technologies Into Home-Based Telerehabilitation: Opportunities and Challenges in Light of COVID-19 Pandemic

Abstract

The COVID-19 pandemic has highlighted the need for advancing the development and implementation of novel means for home-based telerehabilitation in order to enable remote assessment and training for individuals with disabling conditions in need of therapy. While somatosensory input is essential for motor function, to date, most telerehabilitation therapies and technologies focus on assessing and training motor impairments, while the somatosensorial aspect is largely neglected. The integration of tactile devices into home-based rehabilitation practice has the potential to enhance the recovery of sensorimotor impairments and to promote functional gains through practice in an enriched environment with augmented tactile feedback and haptic interactions. In the current review, we outline the clinical approaches for stimulating somatosensation in home-based telerehabilitation and review the existing technologies for conveying mechanical tactile feedback (i.e., vibration, stretch, pressure, and mid-air stimulations). We focus on tactile feedback technologies that can be integrated into home-based practice due to their relatively low cost, compact size, and lightweight. The advantages and opportunities, as well as the long-term challenges and gaps with regards to implementing these technologies into home-based telerehabilitation, are discussed.

Barriers and Challenges of Implementing Telerehabilitation: A Systematic Review

“…Other challenges mentioned in providing TR for individuals with spinal cord injury in this study included a tendency to conventional rehabilitation methods due to the ease of informing the therapist of their sexual problems; in providing TR, the lack of technological advancement for it remained an obstacle despite advances in telemedicine [10] Sometimes, devices and technologies used in TR (tactile feedback technology for motor impairments) have limitations that may lead to poor patient satisfaction and complicate performing TR. These disadvantages include the unpleasant feeling, the different perceptions, and the unpleasant sensation of different patients from the vibration of the device on their body [11]. Providing proper equipment was another challenge to TR implementation.…”

Modified Functional Reach Test: Upper-Body Kinematics and Muscular Activity in Chronic Stroke Survivors

“…It could also be transposed or coupled with marker-less algorithms for movement analysis as performed in [ 57 , 58 , 59 , 60 , 61 ], which are taking place in research and in the clinical practice to facilitate the clinical assessments [ 58 ]. Currently, given the pandemic situation, those could be even more important, since they can facilitate clinical assessments from home and/or telerehabilitation, also it may be coupled with haptic feedback to improve its outcome [ 62 ].…”

Telerehabilitation—A Viable Option for the Recovery of Post-Stroke Patients

“…For many health services, it became a necessity in order to maintain social distancing and decrease the risk of viral transmission while meeting the constant demands of healthcare [40][41][42]. During the COVID-19 pandemic, telerehabilitation is a solution to continue the recovery of post-stroke patients without the consumption of protective equipment, while limiting viral transmission risk in a group that is already vulnerable [43,44].…”

“…The stimulation of the sense of touch, usually done by the therapist during in-person sessions by touching the patient at key moments in order to rectify, explain or encourage patient's movement, is also missing during teletherapy, and patients perceive this as a limitation. Handelzalts et al addressed this limitation by using vibrations generated by a wearable device [44].…”