Search Results (124)

Background/Objectives: Patients with inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS) exhibit complex clinical profiles due to autonomic dysfunction. While sinus node sparing (SNS) hybrid ablation is emerging as a promising therapy, there are no established guidelines worldwide for post-procedure patient management and care is mainly based on telemonitoring. In contrast, our hybrid cardiac rehabilitation (HCR) program integrates inpatient care and home-based telerehabilitation. We aim to evaluate the implementation of the HCR program, patient acceptance and adherence, and the effectiveness of the Malmö POTS scoring system in monitoring disease progression and rehabilitation outcomes. Methods: Patients underwent a personalized HCR program after SNS. The program included early mobilization, psychological support, respiratory therapy, and structured exercise. Clinical outcomes were assessed using symptom burden (Malmö POTS score), ECG parameters, exercise duration, perceived exertion, and rehabilitation adherence. Results: All patients completed the inpatient phase, and 87% completed the home-based phase. In the early postoperative period, pericarditis, anemia, and benign rhythm disturbances were mild and self-limiting. The Malmö POTS score decreased from 65.3 to 25.7. Lower perceived exertion early in the program correlated with clinical improvement. At the 2-month follow-up, 81% of patients no longer met the clinical criteria for IST/POTS without the use of medications. The program was evaluated as safe, feasible, and well-tolerated, with high patient satisfaction. Conclusions: A well-organized hybrid cardiac rehabilitation program after SNS is feasible, safe, and well-tolerated in IST/POTS patients. The Malmö POTS score may support outcome monitoring. The integration of individualized training and telemedicine represents a promising development for patients post-SNS ablation. While this study demonstrates feasibility and potential benefits, further controlled studies are needed to evaluate its impact on long-term recovery and symptom control. Full article

Neurodevelopmental disorders are one of the most prevalent conditions today, and among the limitations in activity and restrictions in the participation of children and their families, we find intervention in activities of daily living; therefore, research focused on outcome measurement is one of the most active lines, and after COVID-19, telerehabilitation has garnered special interest. Background/Objectives: The study objective was to evaluate the effectiveness of a mobile health (mHealth) application in improving the performance of activities of daily living in children with neurodevelopmental disorders. Methods: The study employed a quasi-experimental design with a control group, using a fully remote mHealth-based intervention. The instruments used were a sociodemographic ad hoc, Pediatric Evaluation of Disability Inventory Computer, Family Outcomes Survey, Family Confidence Scale, and System Usability Scale. The final sample consisted of 13 participants. Results: The mHealth intervention showed significant improvements in occupational performance in the experimental group, especially in the global score and in the Responsibility dimension of the PEDI-CAT. No relevant differences were observed in the CON-FAN and FOS scales between groups, although the latter showed improvements over time. The usability of the app was rated positively (SUS = 69.75). Conclusions: The developed application presents good usability for families of children with neurodevelopmental disorders, but to obtain better outcome measures, the intervention should combine face-to-face sessions and the use of mHealth, as well as employing the family-centered model. Full article

Introduction: Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Methods: Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VO₂max), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. Results: A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VO₂max ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. Conclusions: HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care. Full article

Artificial intelligence (AI) and machine learning (ML) have introduced new approaches to medical rehabilitation. These technological advances facilitate the development of large-scale adaptive rehabilitation platforms that can be tailored to individual patients. This review focuses on key technologies, including AI-driven rehabilitation planning, IoT-based patient monitoring, and Large Language Model (LLM)-powered virtual assistants for patient support. This review analyzes existing systems and examines how technologies can be combined to create comprehensive rehabilitation platforms that provide personalized care. For this purpose, a targeted literature search was conducted across leading scientific databases, including Scopus, Google Scholar, and IEEE Xplore. This process resulted in the selection of key peer-reviewed articles published between 2018 and 2025 for a detailed analysis. These studies highlight the latest trends and developments in medical rehabilitation, showcasing how digital technologies can transform rehabilitation processes and support patients. This review illustrates that AI, the IoT, and LLM-based virtual assistants hold significant promise for addressing current healthcare challenges through their ability to enhance, personalize, and streamline patient care. Full article

Neck pain is a significant global health concern and a leading cause of disability. Conventional clinical neck assessments often rely on maximal Cervical Range of Motion (CROM) measurements, which may not accurately reflect functional limitations experienced during activities of daily living (ADLs). This study introduces a novel approach to evaluate neck functional status by employing a virtual reality (VR) environment to simulate an apple-harvesting task. Three-dimensional head kinematics were continuously recorded in 60 participants (30 with clinically significant neck pain and 30 asymptomatic) as they performed the task. Spectral analysis of the data revealed that individuals with neck pain exhibited slower head rotation speed, particularly in the transverse and frontal planes, compared to the pain-free group, as evidenced by higher spectral power in the low-frequency band [0, 0.1] Hz and lower power in the [0.1, 0.5] Hz band. Furthermore, participants with neck pain required significantly more time to complete the apple-harvesting task. The VR system demonstrated high usability (SUS score = 84.21), and no adverse effects were reported. These findings suggest that VR-based assessment during simulated ADLs can provide valuable information about the functional impact of neck pain beyond traditional CROM measurements, potentially enabling remote evaluation and personalized telerehabilitation strategies. Full article

Background/Objectives: Individuals with chronic stroke often experience various impairments, including poor balance, reduced mobility, limited physical activity, and difficulty performing daily tasks. In the context of the COVID-19 pandemic, telerehabilitation (TR) can overcome the barriers of geographical and physical distancing, time, costs, and travel, as well as the anxiety about contracting COVID-19. In this retrospective case-control study, we aim to evaluate the motor and cognitive effects of balance TR training carried out with a sensor-based non-immersive virtual reality system compared to conventional rehabilitation in chronic stroke patients. Methods: Twenty chronic post-stroke patients underwent evaluation for inclusion in the analysis through an electronic recovery data system. The patients included in the study were divided into two groups with similar medical characteristics and duration of rehabilitation training. However, the groups differed in the type of rehabilitation approach used. The experimental group (EG) received TR with a sensor-based VR device, called VRRS—HomeKit (n. 10). In contrast, the control group (CG) underwent conventional home-based rehabilitation (n. 10). Results: At the end of the training, we observed significant improvements in the EG in the 10-m walking test (10MWT) (p = 0.01), Timed-Up-Go Left (TUG L) (p = 0.01), and Montreal Cognitive Assessment (MoCA) (p = 0.005). Conclusions: In our study, we highlighted the potential role of sensor-based virtual reality TR in chronic stroke patients for improving lower limb function, suggesting that this approach is feasible and not inferior to conventional home-based rehabilitation. Full article

Telerehabilitation, a specialized domain within telemedicine, supports remote physical rehabilitation and progress monitoring. Wearable sensors can improve this service by providing reliable monitoring of movement parameters, offering objective information into patients’ rehabilitation sessions. This study presents the development and validation of a telerehabilitation system including a rehabilitation protocol, low-cost wearable inertial measurement units (IMUs) and a set of metrics descriptive of movement capacity to analyze rehabilitation exercises. Eleven medically stable elders (9 females, 2 males; age: 72.6 ± 5.0 years; height: 1.66 ± 0.09 m; mass: 67.8 ± 9.8 kg) performed 12 rehabilitation upper/lower limb and trunk exercises. Movement analysis was conducted using a prototypical IMU sensor and commercially available IMU as a reference. Each exercise was automatically segmented into single repetitions, from which selected metrics were computed. Bland–Altman analysis was performed to evaluate measurement agreement and consistency between the systems across all parameters. Results indicate acceptable measurement agreement for key rehabilitation metrics, including movement quantity, accelerations intensity, and movement smoothness. However, angular velocity and movement stability reveal technical limitations requiring refinement prior to clinical implementation. Balancing measurement reliability and affordability of telerehabilitation system remains a crucial factor to offer an effective service to individuals with diverse health conditions. Full article

(1) Background: Digital Health Technology (DHT) is an emerging method for stroke rehabilitation that could potentially be very effective in solving different problems in the therapeutic process. This study aims to explore the use of DHT for stroke rehabilitation in Canada, providing insights into how current technologies have been implemented and identifying gaps to inform future decision-making in clinical, research, and policy settings in the Canadian setting. (2) Methods: We followed the Arksey and O’Malley framework for scoping reviews. The original search was created in Medline (Ovid) and translated to PsycINFO (Ovid), Scopus, and CINAHL with Full Text (EBSCOhost). To locate grey literature, we searched Canadian Theses and Google. The search yielded 163 articles, of which we included 14 (8.6%) in the review. (3) Results: Fourteen studies published between 2010 and 2022 in Canada varied in design: 4 qualitative (28.6%), 4 randomized clinical trials (RCTs) (28.6%), 2 mixed methods (14.3%), and other types. The main goals included assessing intervention effectiveness (35.7%), client (28.6%) and clinician (28.6%) perceptions of technology, and feasibility (21.5%). Most studies focused on upper extremity (UE) function (85.71%), with some addressing walking speed (7.1%) and sitting balance (7.1%). Research mainly targeted the chronic phase of stroke (64.3%). Studies were conducted in home (50%) and institutional settings (42.9%). Technologies included sensors (50%), virtual reality (VR) (42.9%), games (28.6%), telerehabilitation (28.6%), and robots (14.3%). (4) Conclusions: This scoping review offers key insights into the use of DHTs for stroke rehabilitation in Canada, highlighting the types of technologies, their effectiveness, and the facilitators and barriers to adoption. These technologies show promise in improving patient outcomes, and their integration into Canadian healthcare systems presents a significant opportunity to enhance stroke rehabilitation. Full article

Chronic respiratory diseases (CRDs) are a significantly major cause of mortality in Saudi Arabia, with their progression frequently involving comorbidities and exacerbations that extend beyond the lungs. This review considers the current state of pulmonary rehabilitation (PR) in Saudi Arabia, this being a well-known non-pharmacological intervention to help control and reduce the burden of CRDs, highlighting the intervention’s availability, multidisciplinary approach, and integration within the healthcare system, as well as examining the diseases’ contribution to overall symptom severity, impairing daily activities and significantly worsening the patient’s quality of life. Although PR is strongly recommended for managing CRDs, its utilization in Saudi Arabia remains limited or unavailable in many regions. Key barriers to PR access include inadequate awareness among healthcare providers and patients, logistical challenges, and an insufficient number of specialized facilities and trained professionals. Expanding PR programs in Saudi Arabia requires addressing geographical barriers, ensuring adequate space, resources, and trained personnel, and raising awareness among healthcare providers through education and training. Integrating PR principles into medical education and offering incentives for specialization can help overcome personnel shortages. Additionally, promoting telerehabilitation can enhance patient compliance and ensure the long-term success of PR programs. These initiatives aim to optimize PR services and improve patient outcomes across the nation. Full article

Parkinson’s disease (PD) and multiple sclerosis (MS) are two chronic neurological diseases (CNDs) that have a high demand for early and continuous rehabilitation. However, accessing professional care remains a challenge, making it a key priority to identify sustainable solutions for ensuring early rehabilitation availability. Objective: The FIT4TeleNEURO pragmatic trial proposes to investigate, in real-life care settings, the superiority in terms of the effectiveness of early rehabilitation intervention with harmonized, mix-model telerehabilitation (TR) protocols (TR single approach, task-oriented—TRsA; TR combined approach, task-oriented and impairment-oriented—TRcA) compared to conventional management (control treatment, CeT) in people with PD and MS. Design, and Methods: This multicenter, randomized, three-treatment arm pragmatic trial will involve 300 patients with CNDs (PD, N = 150; MS, N = 150). Each participant will be randomized (1:1:1) to the experimental groups (20 sessions of TRsA or TRcA according to a mix-model—3 asynchronous + 1 synchronous session/week) or the control group (20 sessions of CeT). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and follow-up (T2, 3 months after the end of the treatment). A multidimensional evaluation (cognitive, motor, and quality of life domains) will be conducted at each time point of assessment (T0; T1; T2). The primary outcome measures will be the assessment of change (T0 vs. T1 vs. T2) in static and dynamic balance, measured using the Mini-Balance Evaluation Systems Test. Usability and acceptability assessment will be also investigated. Expected Results: Implementing TR protocols will enable a more targeted and efficient response to the growing demand for rehabilitation in the early stages of CNDs. Both the TRsA and TRcA approaches are expected to be more effective than CeT, with the combined approach likely providing greater benefits in secondary outcome measures. Finally, the acceptability of the asynchronous modality could open the door to scalable solutions, such as digital therapeutics. Full article

Background: Post COVID-19 Condition is a recently recognized syndrome characterized by the persistence of various symptoms, including dyspnea, physical and mental fatigue, and post-exertional malaise. Currently, there is no established treatment or clear consensus on the effectiveness of rehabilitation, and given that patients could benefit from home-based rehabilitation, telerehabilitation, defined as remote rehabilitation using telematic systems, may be an option to reach more of the population with persistent COVID-19 symptoms. Therefore, it is necessary to show the efficacy of this telematic approach and the benefits of a multimodal rehabilitation strategy in these patients. Methods: Patients underwent home rehabilitation using a 12-week synchronous telerehabilitation system. The intervention included therapeutic education and physical and respiratory rehabilitation. The following variables were analyzed: Fatigue, quality of life, dyspnea, respiratory strength, aerobic capacity, and upper and lower limb strength. Conclusions: After 12 weeks, significant improvements were found in fatigue, aerobic capacity, and limb and respiratory strength. However, no improvement was found in dyspnea scores, which did not correlate with respiratory strength. Interestingly, a post-intervention correlation emerged between the distance covered in aerobic capacity and perceived fatigue, suggesting that asynchronous telerehabilitation could be a viable treatment strategy for these patients. Full article

Artificial intelligence (AI) has revolutionized telerehabilitation by integrating machine learning (ML), big data analytics, and real-time feedback to create adaptive, patient-centered care. AI-driven systems enhance telerehabilitation by analyzing patient data to personalize therapy, monitor progress, and suggest adjustments, eliminating the need for constant clinician oversight. The benefits of AI-powered telerehabilitation include increased accessibility, especially for remote or mobility-limited patients, and greater convenience, allowing patients to perform therapies at home. However, challenges persist, such as data privacy risks, the digital divide, and algorithmic bias. Robust encryption protocols, equitable access to technology, and diverse training datasets are critical to addressing these issues. Ethical considerations also arise, emphasizing the need for human oversight and maintaining the therapeutic relationship. AI also aids clinicians by automating administrative tasks and facilitating interdisciplinary collaboration. Innovations like 5G networks, the Internet of Medical Things (IoMT), and robotics further enhance telerehabilitation’s potential. By transforming rehabilitation into a dynamic, engaging, and personalized process, AI and telerehabilitation together represent a paradigm shift in healthcare, promising improved outcomes and broader access for patients worldwide. Full article

The T-Rehab System delivers a semi-immersive tele-rehabilitation experience by integrating Affective Computing (AC) through facial expression analysis and contactless heartbeat monitoring. T-Rehab closely monitors patients’ mental health as they engage in a personalized, semi-immersive Virtual Reality (VR) game on a desktop PC, using a webcam with MediaPipe to track their hand movements for interactive exercises, allowing the system to tailor treatment content for increased engagement and comfort. T-Rehab’s evaluation comprises two assessments: system performance and cognitive walkthroughs. The first evaluation focuses on system performance, assessing the tested game, middleware, and facial emotion monitoring to ensure hardware compatibility and effective support for AC, gaming, and tele-rehabilitation. The second evaluation uses cognitive walkthroughs to examine usability, identifying potential issues in emotion detection and tele-rehabilitation. Together, these evaluations provide insights into T-Rehab’s functionality, usability, and impact in supporting both physical rehabilitation and emotional well-being. The thorough integration of technology inside T-Rehab ensures a holistic approach to tele-rehabilitation, allowing patients to participate comfortably and efficiently from anywhere. This technique not only improves physical therapy outcomes but also promotes mental resilience, marking an important step advance in tele-rehabilitation practices. Full article

Chronic ankle instability (CAI), due to its chronic nature and biomechanical complexity, is well-suited for continuous monitoring and tele-rehabilitation using wearable sensor technology. This study assessed whether a smart insole system, equipped with 4 force-sensing resistor sensors and an inertial measurement unit, combined with functional tests and biomechanical indices, could distinguish CAI patients from healthy controls. A total of 21 CAI patients (23.8 ± 5.1 years) and 16 controls (22.62 ± 2.60 years) completed a battery of functional performance tests while wearing the smart insole system. The results showed an increased medial-lateral pressure ratio in the CAI during heel raise (p = 0.031, effect size = 0.82) and hop tests, suggesting an everted foot position. Significant deviations in center-of-pressure trajectory during double-leg heel raises (p = 0.005, effect size = 1.10) suggested asymmetric motion coordination, while compensatory fluctuations of the lifted limb during single-leg balance tests (p = 0.011, effect size = 1.03) were greater in CAI patients. These findings facilitated the development of features to characterize CAI-specific movement patterns. Together, this system shows promise as a quantitative assessment tool for CAI, supporting improved treatment outcomes through tele-rehabilitation. Full article

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) have a substantial effect on overall disease management, health system costs, and patient outcomes. However, exacerbations are often underdiagnosed or recognized with great delay due to several factors such as patients’ inability to differentiate between acute episodes and symptom fluctuations, delays in seeking medical assistance, and disparities in dyspnea perception. Self-management intervention plans, telehealth and smartphone-based programs provide educational material, counseling, virtual hospitals and telerehabilitation, and help COPD patients to identify exacerbations early. Moreover, biomarkers such as blood eosinophil count, fibrinogen, CRP, Serum amyloid A(SAA),together with imaging parameters such as the pulmonary artery-to-aorta diameter ratio, have emerged as potential predictors of exacerbations, yet their clinical utility is limited by variability and lack of specificity. In this review, we provide information regarding the importance of the early identification of exacerbation events in COPD patients and the available methods which can be used for this purpose. Full article