Perspectives on the Evolution of Mobile (mHealth) Technologies and Application to Rehabilitation

Dicianno, Brad E.; Parmanto, Bambang; Fairman, Andrea D.; Crytzer, Theresa M.; Yu, Daihua X.; Pramana, Gede; Coughenour, Derek; Petrazzi, Alan A.

doi:10.2522/ptj.20130534

Cited by 142 publications

(96 citation statements)

References 51 publications

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“…Apps könnten unter anderem zu Kosteneinsparungen füh-ren, den Zugang zu evidenzbasierten Angeboten fördern [Endl et al, 2015;Aitken, 2015;Kuhn und Amelung, 2016], die Adhärenz steigern [Aitken, 2015;Kuhn und Amelung, 2016], die Datenverfügbarkeit verbessern [Charani et al, 2014] und zu einer stärken Patientenzentrierung, Patientenautonomie und Selbstbestimmung führen [Kuhn und Amelung, 2016;Nasi et al, 2015;Klasnja und Pratt, 2012;Dicianno et al, 2015;Pejovic et al, 2015;Gupta et al, 2013]. Auch bieten Apps die Chance, eine Anschlussbehandlung, Nachsorge oder Step-Down-Behandlung zu ermöglichen und zu verbessern sowie Betroffenen, die eine therapeutische Behandlung entweder ablehnen oder mit langen Wartezeiten konfrontiert sind, niederschwellig Hilfestellung anzubieten [Price et al, 2014;Andrade et al, 2014].…”

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«Hilfe aus dem App-Store?»: Eine systematische Übersichtsarbeit und Evaluation von Apps zur Anwendung bei Depressionen

et al. 2018

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Hintergrund: In Deutschland sind etwa 4,9 Millionen Menschen an Depressionen erkrankt. Depressionen sind für die Betroffenen und die Gesellschaft mit enormen Belastungen verbunden. Gesundheits-Apps haben hier das Potenzial, die Versorgungslage zu verbessern. Das Ziel dieser systematischen Übersichtsarbeit ist es, die Qualität, Inhalte und Praxisrelevanz von deutschsprachigen Apps für die Anwendung bei Depressionen zu untersuchen. Methode: Die deutschen Google-Play- und iTunes-Stores wurden systematisch nach Apps durchsucht, die explizit mit der Thematik «Depression/Depressivität» warben. Die so ermittelten Apps wurden mithilfe einer Skala zur Einschätzung der Qualität (Mobile Application Rating Scale) von 2 unabhängigen Gutachtern bewertet. Apps mit überdurchschnittlichem Rating wurden von 2 praktisch tätigen Verhaltenstherapeuten im Hinblick auf ihren Nutzen für die klinische Praxis beurteilt. Ergebnisse: Von 1156 identifizierten Apps wurden 38 eingeschlossen. Inhaltlich reichten diese von Informations- bis zu Interventions-Apps. Die Apps wiesen eine mittlere Gesamtqualität auf (M = 3,01; Standardabweichung = 0,56). Vier Apps zeigten überdurchschnittliche Werte. Sie wurden durch 2 Psychotherapeuten getestet und als bedingt empfehlenswert für die klinische Praxis beurteilt. Zu keiner der eingeschlossenen Apps konnte eine Wirksamkeitsstudie gefunden werden. Schlussfolgerungen: Deutschsprachige Depressions-Apps weisen qualitative Mängel auf. Zusätzlich fehlt es an klinischen Studien zum Nutzen und zu Risiken, weshalb der Einsatz in der klinischen Praxis nur bedingt empfohlen werden kann. Ein Gütesiegel für qualitativ hochwertige und praxisrelevante Gesundheits-Apps könnte Nutzer vor Fehlinformationen und Missbrauch schützen und Leistungserbringern den Einsatz digitaler Medien substanziell erleichtern.

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«Hilfe aus dem App-Store?»: Eine systematische Übersichtsarbeit und Evaluation von Apps zur Anwendung bei Depressionen

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“…67 The American Physical Therapy Association and American Occupational Therapy Association have endorsed tele-health services especially to overcome lack of access to in-person care. 49 Along with this trend comes the so-called quantified self movemen t , which aims to incorporate technologies for frequent, routine data acquisition about health. Its goal, which is consistent with mHealth devices, telehealth programs, and tele-rehabilitation via a RIoT, is to enable more transparency, self-knowledge and customization about care, improve decision-making about health, and develop a patient-centric approach to monitoring a range of metrics about health.…”

Section: Solutionsmentioning

confidence: 99%

A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Dobkin

2016

Neurorehabil Neural Repair

108

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Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

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“…Mobile health (mHealth) apps can provide a ubiquitous channel for delivering convenient and personalized telerehabilitation to people with MS [19]. These apps can enable researchers to deliver and quantify “precise” doses of exercise that are customized to the unique needs of the end user and can be accessed in the comfort of one’s home [20].…”

Section: Introductionmentioning

confidence: 99%

TEAMS (Tele-Exercise and Multiple Sclerosis), a Tailored Telerehabilitation mHealth App: Participant-Centered Development and Usability Study

Thirumalai¹,

Rimmer²,

Johnson³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundPeople with multiple sclerosis face varying levels of disability and symptoms, thus requiring highly trained therapists and/or exercise trainers to design personalized exercise programs. However, for people living in geographically isolated communities, access to such trained professionals can be challenging due to a number of barriers associated with cost, access to transportation, and travel distance. Generic mobile health exercise apps often fall short of what people with multiple sclerosis need to become physically active (ie, exercise content that has been adapted to accommodate a wide range of functional limitations).ObjectiveThis usability study describes the development process of the TEAMS (Tele-Exercise and Multiple Sclerosis) app, which is being used by people with multiple sclerosis in a large randomized controlled trial to engage in home-based telerehabilitation.MethodsTwenty-one participants with disabilities (10 people with multiple sclerosis) were involved in the double iterative design, which included the simultaneous development of the app features and exercise content (exercise videos and articles). Framed within a user-centered design approach, the development process included 2 stages: ground-level creation (focus group followed by early stage evaluations and developments), and proof of concept through 2 usability tests. Usability (effectiveness, usefulness, and satisfaction) was evaluated using a mixed-methods approach.ResultsDuring testing of the app’s effectiveness, the second usability test resulted in an average of 1 problem per participant, a decrease of 53% compared to the initial usability test. Five themes were constructed from the qualitative data that related to app usefulness and satisfaction, namely: high perceived confidence for app usability, positive perceptions of exercise videos, viable exercise option at home, orientation and familiarity required for successful participation, and app issues. Participants acknowledged that the final app was ready to be delivered to the public after minor revisions. After including these revisions, the project team released the final app that is being used in the randomized controlled trial.ConclusionsA multi-level user-centered development process resulted in the development of an inclusive exercise program for people with multiple sclerosis operated through an easy-to-use app. The promotion of exercise through self-regulated mHealth programs requires a stakeholder-driven approach to app development. This ensures that app and content match the preferences and functional abilities of the end user (ie, people with varying levels of multiple sclerosis).

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Perspectives on the Evolution of Mobile (mHealth) Technologies and Application to Rehabilitation

Cited by 142 publications

References 51 publications

«Hilfe aus dem App-Store?»: Eine systematische Übersichtsarbeit und Evaluation von Apps zur Anwendung bei Depressionen

«Hilfe aus dem App-Store?»: Eine systematische Übersichtsarbeit und Evaluation von Apps zur Anwendung bei Depressionen

A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

TEAMS (Tele-Exercise and Multiple Sclerosis), a Tailored Telerehabilitation mHealth App: Participant-Centered Development and Usability Study

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