Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

Healthcare, 2023 · DOI: 10.3390/healthcare11202751 · Published: October 17, 2023

Assistive Technology Healthcare Telehealth & Digital Health

Simple Explanation

Chronic diseases often lead to disability, and many patients don't get enough exercise to manage their conditions effectively. Technologies like exoskeletons and virtual reality could bring rehab into homes, improving recovery and self-management. Despite the potential, these technologies aren't widely used. This review explores the need for these technologies, their effectiveness, and the obstacles to putting them into practice for common conditions. Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative Review

Key Findings

1
Exoskeletons show promise in improving walking and balance for stroke patients, but study quality varies. Evidence for musculoskeletal conditions, diabetes, pulmonary conditions and heart disease is limited.
2
Virtual reality can improve dizziness in vestibular disorders and may improve balance and mobility after stroke. Cardiac rehabilitation shows the most beneﬁcial effect of the use of AR/VR and remote monitoring systems
3
Remote monitoring, especially in cardiac rehab, shows benefits comparable to traditional rehab, but long-term results and cost-effectiveness need more study.

Research Summary

This review examines the clinical need, evidence, obstacles, and implementation strategies for using exoskeletons, virtual reality, and remote monitoring to improve physical function at home for chronic conditions. The technologies reviewed offer potential for long-term adherence to rehabilitation treatments at home, but effective evidence is still limited. More research is needed to integrate these technologies effectively. Implementation science, with hybrid effectiveness-implementation studies, can help bridge the gap between technological advances and clinical practice, focusing on patient needs, effectiveness, health systems, and implementation outcomes.

Practical Implications

Home-Based Rehabilitation

Technology can potentially extend rehab beyond the clinic and into the home environment, increasing access and adherence.

Personalized Treatment

Remote monitoring and VR/AR can offer personalized feedback and tailored exercises, adapting to individual needs.

Hybrid Research Models

Adopting hybrid effectiveness-implementation study designs can accelerate technology adoption by considering both clinical efficacy and real-world implementation factors.

Study Limitations

1
Lack of research on usability and patient-centered outcomes
2
Difficulty with comparisons due to inconsistent reporting and heterogeneity
3
Lack of healthcare service outcomes (efficiency, timeliness, reimbursement, safety, and equity)

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