Search Results (29)

Background/Objectives: This study evaluates the effects of a personalized exercise program on symptoms (pain, fatigue, sleep, cognitive function, physical function), resilience, and health-related quality of life (HRQOL) and compares the effectiveness of in-person versus telehealth delivery. Methods: A secondary data analysis was conducted on two 12-week randomized control pilot studies for solid tumor cancer survivors. One study involved in-person home visits with telephone follow-ups. The second utilized weekly exercise recommendations via a smartphone app. Both studies had control participants who received the standard care. Symptoms, resilience, and HRQOL were measured at baseline and after 12 weeks. Paired t-tests were conducted for intervention effects and ANCOVA for group differences, adjusting for age and education. Results: The analysis included 75 program completers: 15 in-person (iHBE), 38 telehealth (TEHE), and 22 who received standard care. Those receiving exercise interventions reported improvements in physical (t = 3.0, p < 0.01) and mental fatigability (t = 3.1, p < 0.01) at program completion compared to baseline. Comparing the mean changes between participants receiving exercise interventions in-person and via telehealth, there were no significant differences between the two delivery methods except perceived visuo-perceptual cognitive difficulty (F = 3.55, p = 0.027), where telehealth showed a slight advantage. Conclusions: The study provides initial evidence of the effectiveness of a telehealth personalized exercise on fatigability and cognitive difficulty, suggesting it is a potential viable alternative to in-person intervention. Further research with a larger cohort is essential to ascertain the effects of these interventional modalities on cancer-related health outcomes. Full article

Background/Objectives: Telehealth enhances access to specialty care, but stakeholder perspectives are often overlooked. The objective was to evaluate participant and provider satisfaction with a novel telehealth-enabled home safety program. Methods: This is a sub-investigation of a non-randomized pilot study of a novel telehealth-enabled home safety program that enrolled 23 persons with Parkinson’s Disease (PwPs) at risk for falls and their respective care partners (CPs). Dyads participated in four to six televisits over three months, where they performed “virtual home tours” using a mobile platform (tablet mounted on a rolling stand) with a physical therapist to identify and mitigate environmental fall hazards. Satisfaction was assessed using PI-developed surveys and open feedback. Mobile platform usability was assessed with the System Usability Scale (SUS). Results: A total of 95.65% of dyads were very to extremely satisfied with the entire program overall, and the therapist indicated the same for 73.91% of the dyads. Additionally, 95.65% of dyads reported gaining new awareness of home fall hazards. Difficulties maneuvering the mobile platform, using a tablet, and connectivity issues were common challenges noted. The mean score on SUS for the mobile platform was 65, indicating poor perceived usability, and most dyads indicated they would have preferred using a smartphone for the program. Other priorities, including competing health and personal obligations, along with resistance to change, were the primary barriers to implementing program recommendations. Conclusions: Our novel telehealth-enabled home safety program was well-received by patients and the study therapist. Using a smartphone and troubleshooting connectivity issues might help further improve the usability and accessibility of this program. Full article

Background: Traditionally, auditory rehabilitation in people with hearing loss has sought training in auditory skills to achieve an understanding of sound messages for communication. Assistive or supportive technology is limited to hearing aids that transmit sound through the air or bone to be used by the individual, and only in recent times have technologies for rehabilitation, of high cost and difficult access, begun to be used, employed by audiology professionals. Objective: The objective of this study was to compile the evidence reported in the literature on the use of technology in auditory rehabilitation for the improvement of hearing skills in people with hearing loss, beyond hearing aids and cochlear implants. Method: A systematic review of the literature was conducted between 2018 and 2024 in PubMed, Scopus, and Web of Science databases, using as search terms Technology AND “Auditory Rehabilitation” validated in DeCS and MeSH thesauri; the PICO method was used to propose the research question, and the PRISMA strategy was used for the inclusion or exclusion of the articles to be reviewed. Results: In the first search, 141 documents were obtained. Subsequently, inclusion criteria, such as development with vibrotactile stimulation, Information and Communication Technologies (ICTs), among others, and exclusion criteria, such as those related to cochlear implants and air conduction hearing aids, were applied, and finally, articles related to natural language processing, and other systematic reviews were excluded so that the database was reduced to 14 documents. To this set, due to their relevance, two papers were added, for a total of sixteen analyzed. Conclusions: There are solutions ranging from the use of smartphones for telehealth to solutions with multiple technologies, such as the development of virtual environments with vibrotactile feedback. Hearing-impaired people and even professionals in this area of healthcare have a high level of acceptance of the use of technology in rehabilitation. Finally, this article highlights the crucial role of technology in auditory rehabilitation, with solutions that improve hearing skills and the positive acceptance of these tools by patients and audiology professionals. Full article

Introduction: Remote health monitoring plays a crucial role in telehealth services and the effective management of patients, which can be enhanced by vital sign prediction from facial videos. Facial videos are easily captured through various imaging devices like phone cameras, webcams, or surveillance systems. Methods: This study introduces a hybrid deep learning model aimed at estimating heart rate (HR), blood oxygen saturation level (SpO2), and blood pressure (BP) from facial videos. The hybrid model integrates convolutional neural network (CNN), convolutional long short-term memory (convLSTM), and video vision transformer (ViViT) architectures to ensure comprehensive analysis. Given the temporal variability of HR and BP, emphasis is placed on temporal resolution during feature extraction. The CNN processes video frames one by one while convLSTM and ViViT handle sequences of frames. These high-resolution temporal features are fused to predict HR, BP, and SpO2, capturing their dynamic variations effectively. Results: The dataset encompasses 891 subjects of diverse races and ages, and preprocessing includes facial detection and data normalization. Experimental results demonstrate high accuracies in predicting HR, SpO2, and BP using the proposed hybrid models. Discussion: Facial images can be easily captured using smartphones, which offers an economical and convenient solution for vital sign monitoring, particularly beneficial for elderly individuals or during outbreaks of contagious diseases like COVID-19. The proposed models were only validated on one dataset. However, the dataset (size, representation, diversity, balance, and processing) plays an important role in any data-driven models including ours. Conclusions: Through experiments, we observed the hybrid model’s efficacy in predicting vital signs such as HR, SpO2, SBP, and DBP, along with demographic variables like sex and age. There is potential for extending the hybrid model to estimate additional vital signs such as body temperature and respiration rate. 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

The aim of this study is to address the issues identified in previous reviews and meta-analyses regarding the progress of patient experience literature and to highlight the most important concepts specifically related to digital health technologies. To do so, we have carried out a comprehensive analysis of the literature on patient experience in the category of health science services databases over the past decade and identified the tools related to digital health technologies within these studies. This is a bibliometric study based on data obtained from the Web of Science and Scopus between the years 2014 to and 2024 by using 11 search terms. In this review, a total of 21,392 publications from patient experience literature over the last decade were analyzed. Keywords were grouped by showing their co-occurrence using bibliometric and scientific mapping analyzing methods. The development of digitalization and digital tools has contributed to the advancement of theory in the field of digital health, eHealth, electronic health records, health information technology, the internet, mhealth, mobile applications, mobile health, patient portals, smartphones, social media, telemonitoring, web, artificial intelligence, machine learning, virtual reality, telehealth, telemedicine, telerehabilitation, and virtual care. These developments have provided sustainable digital health benefits in the development of patient experience theories. The findings of this study emphasize that digital health tools cover a wide area of research, and the application of information and communication technologies goes beyond the field of medicine and covers the broad field of healthcare. Full article

Stride-to-stride fluctuations during walking reflect age-related changes in gait adaptability and are estimated with nonlinear measures that confine data collection to controlled settings. Smartphones, with their embedded accelerometers, may provide accessible gait analysis throughout the day. This study investigated age-related differences in linear and nonlinear gait measures estimated from a smartphone accelerometer (SPAcc) in an unconstrained, free-living environment. Thirteen young adults (YA) and 11 older adults (OA) walked within a shopping mall with a SPAcc placed in their front right pants pocket. The inter-stride interval, calculated as the time difference between ipsilateral heel contacts, was used for dependent measures calculations. One-way repeated-measures analysis of variance revealed significant (p < 0.05) age-related differences (mean: YA, OA) for stride-time standard deviation (0.04 s, 0.05 s) and coefficient of variation (3.47%, 4.16%), sample entropy (SaEn) scale 1 (1.70, 1.86) and scale 3 (2.12, 1.80), and statistical persistence decay (31 strides, 23 strides). The fractal scaling index was not different between groups (0.93, 0.95), but exceeded those typically found in controlled settings, suggesting an upregulation in adaptive behaviour likely to accommodate the increased challenge of free-living walking. These findings support the SPAcc as a viable telehealth instrument for remote monitoring of gait dynamics, with implications for unsupervised fall-risk assessment. Full article

Background/Objectives: The aim of the narrative review is to identify information on the impact of technological interventions (such as telehealth and mobile health) on the health promotion of cardiac patients from diverse populations. Methods: The online databases of PubMed and the Cochrane Library were searched for articles in the English language regarding technological interventions for health promotion in cardiac patients. In addition, a methodological quality control process was conducted. Exclusion was based on first reading the abstract, and then the full manuscript was scanned to confirm that the content was not related to cardiac patients and technological interventions. Results: In all, 11 studies were included in this review after quality control analysis. The sample size reported in these studies ranged from 12 to 1424 subjects. In eight studies mobile phones, smartphones, and apps were used as mHealth interventions with tracking and texting components; two studies used videoconferencing as a digital intervention program, while three studies focused on using physical activity trackers. Conclusions: This review highlights the positive aspects of patient satisfaction with the technological interventions including, but not limited to, accessibility to health care providers, sense of security, and well-being. The digital divide becomes apparent in the articles reviewed, as individuals with limited eHealth literacy and lack of technological knowledge are not motivated or able participate in these interventions. Finding methods to overcome these barriers is important and can be solved to some extent by providing the technology and technical support. Full article

Background/Objective: Caregivers from the Millennial generation are an emerging and understudied group of unpaid care providers in America who may benefit from digitally delivered support. To inform the design/tailoring of interventions for this group, we aimed to understand how Millennials may differ from other generations of caregivers regarding digital health-related technology use. Methods: Using the Health Information National Trends Survey (HINTS), Version 6, we conducted a cross-sectional study comparing health technology access and use across four generations of unpaid caregivers (n = 545; Millennials, Gen X, Baby Boomers, and Silent Generation) of adults with chronic conditions using chi-square and Kruskal–Wallis non-parametric tests. Results: Compared to Baby Boomer and Silent Generation caregivers, Millennial caregivers more frequently reported having a cellular internet connection, using a wearable activity device, a health/wellness mobile application, choosing telehealth appointments for convenience, and most frequently used social media in general and to view health-related videos (ps < 0.005). Additionally, Millennials were more likely to report possessing a smartphone (compared to Gen X and Silent Generation) and more frequently used social media for peer interaction about health (compared to all older generations; ps < 0.005). Conclusion: Millennials differ from older generations of caregivers regarding health-related technology access and use, which may have implications for intervention design and tailoring. Full article

The provision of mobility exercises through a smartphone application (app) for people undertaking neurological rehabilitation may improve mobility outcomes. However, it is difficult for clinicians and consumers to select high-quality, appropriate apps. This review aimed to identify (1) which mobile health (mHealth) apps are suitable for prescribing mobility exercises for adults with neurological health conditions, (2) how well these apps incorporate telehealth strategies, and (3) how well these apps rate in terms of quality and capacity for behaviour change. The Australian Apple iTunes Store was systematically searched, by using a search code and manually, for apps suitable for training mobility in neurological rehabilitation. Additional searches were conducted in known app repositories and for web-based apps. Trained reviewers extracted data from the included apps, including population-specific characteristics; quality, by using the Mobile App Rating Scale (MARS); and behaviour change potential, by using the App Behaviour Change Scale (ABACUS). The included apps (n = 18) provided <50 to >10,000 exercises, many incurred a subscription fee (n = 13), and half included telehealth features. App quality was moderate (mean MARS score of 3.2/5 and SD of 0.5), and potential for behaviour change was poor (mean ABACUS score of 5.7/21 and SD of 2.1). A limited number of high-quality apps are available for the prescription of mobility exercises in people with neurological conditions. Full article

Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare. Full article

The United States Department of Veterans Affairs (VA) uses a systematized approach for disseminating evidence-based, trauma-focused psychotherapies for post-traumatic stress disorder (PTSD). Within this approach, veterans with PTSD must often choose between Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), each delivered in their standard protocols. Many veterans have been greatly helped by this approach. Yet limiting trauma-focused therapy to these two options leaves the VA unable to fully address the needs of a variety of veterans. This limitation, among other factors, contributes to the suboptimal attrition rates within the VA. The present review proposes solutions to address treatment barriers that are both practical (such as time and travel constraints) and psychological (such as resistance to trauma exposure). By reducing barriers, attrition may lessen. Proposed countermeasures against practical barriers include intensive protocols, shortened sessions, telehealth, smartphone application delivery, or any combination of these methods. Countermeasures against psychological barriers include alternative evidence-based treatment programs (such as Acceptance and Commitment Therapy), intensive protocols for exposure-based treatments, and the integration of components from complementary treatments to facilitate PE and CPT (such as Motivational Interviewing or family therapy). By further tailoring treatment to veterans’ diverse needs, these additions may reduce attrition in VA services for PTSD. Full article

mHealth solutions optimize cardiovascular risk factor control in coronary artery disease. The aim of this study was to investigate the influence of mobile app AfterAMI on quality of life in patients after myocardial infarction. 100 participants were randomized (1:1 ratio) into groups: (1) with a rehabilitation program and access to afterAMI or (2) standard rehabilitation alone (control group, CG). 3 questionnaires (MacNew, DASS21 and EQ-5D-5L) were used at baseline, 1 month and 6 months after discharge. Median age was 61 years; 35% of patients were female. At 1 month follow up patients using AfterAMI had higher general quality of life scores both in MacNew [5.78 vs. 5.5 in CG, p = 0.037] and EQ-5D-5L [80 vs. 70 in CG, p = 0.007]. At 6 months, according to MacNew, the app group had significantly higher scores in emotional [6.09 vs. 5.45 in CG, p= 0.017] and physical [6.2 vs. 6 in CG, p = 0.027] aspects. The general MacNew quality of life score was also higher in the AfterAMI group [6.11 vs. 5.7 in CG, p = 0.015], but differences in EQ-5D-5L were not significant. There were no differences between groups in the DASS21 questionnaire. mHealth interventions may improve quality of care in secondary prevention, however further studies are warranted. Full article

Background: The COVID-19 pandemic has accelerated the demand for utilising telehealth as a major mode of healthcare delivery, with increasing interest in the use of tele-platforms for remote patient assessment. In this context, the use of smartphone technology to measure squat performance in people with and without femoroacetabular impingement (FAI) syndrome has not been reported yet. We developed a novel smartphone application, the TelePhysio app, which allows the clinician to remotely connect to the patient’s device and measure their squat performance in real time using the smartphone inertial sensors. The aim of this study was to investigate the association and test–retest reliability of the TelePhysio app in measuring postural sway performance during a double-leg (DLS) and single-leg (SLS) squat task. In addition, the study investigated the ability of TelePhysio to detect differences in DLS and SLS performance between people with FAI and without hip pain. Methods: A total of 30 healthy (nfemales = 12) young adults and 10 adults (nfemales = 2) with diagnosed FAI syndrome participated in the study. Healthy participants performed DLS and SLS on force plates in our laboratory, and remotely in their homes using the TelePhysio smartphone application. Sway measurements were compared using the centre of pressure (CoP) and smartphone inertial sensor data. A total of 10 participants with FAI (nfemales = 2) performed the squat assessments remotely. Four sway measurements in each axis (x, y, and z) were computed from the TelePhysio inertial sensors: (1) average acceleration magnitude from the mean (aam), (2) root-mean-square acceleration (rms), (3) range acceleration (r), and (4) approximate entropy (apen), with lower values indicating that the movement is more regular, repetitive, and predictable. Differences in TelePhysio squat sway data were compared between DLS and SLS, and between healthy and FAI adults, using analysis of variance with significance set at 0.05. Results: The TelePhysio aam measurements on the x- and y-axes had significant large correlations with the CoP measurements (r = 0.56 and r = 0.71, respectively). The TelePhysio aam measurements demonstrated moderate to substantial between-session reliability values of 0.73 (95% CI 0.62–0.81), 0.85 (95% CI 0.79–0.91), and 0.73 (95% CI 0.62–0.82) for aamx, aamy, and aamz, respectively. The DLS of the FAI participants showed significantly lower aam and apen values in the medio-lateral direction compared to the healthy DLS, healthy SLS, and FAI SLS groups (aam = 0.13, 0.19, 0.29, and 0.29, respectively; and apen = 0.33, 0.45, 0.52, and 0.48, respectively). In the anterior–posterior direction, healthy DLS showed significantly greater aam values compared to the healthy SLS, FAI DLS, and FAI SLS groups (1.26, 0.61, 0.68, and 0.35, respectively). Conclusions: The TelePhysio app is a valid and reliable method of measuring postural control during DLS and SLS tasks. The application is capable of distinguishing performance levels between DLS and SLS tasks, and between healthy and FAI young adults. The DLS task is sufficient to distinguish the level of performance between healthy and FAI adults. This study validates the use of smartphone technology as a tele-assessment clinical tool for remote squat assessment. Full article

This pilot study assessed the feasibility of using SwapMyMood, a smartphone application supporting evidence-based strategies for emotion regulation and problem-solving as a supplement to conventional care for military service members and veterans (SM/Vs) experiencing chronic symptoms of mild traumatic brain injury (mTBI) and co-occurring psychological conditions. Eight military SM/Vs were recruited from an intensive outpatient program. Participants were block randomized to an experimental group (conventional care plus use of the SwapMyMood app) or a conventional care only group for six weeks. Conventional care included instruction on problem-solving and emotion regulation strategies using traditional paper manuals and protocols. Effects on the knowledge and use of strategies and related goal attainment were measured. Patient-reported outcomes were measured via several validated problem-solving and emotion regulation scales. No differences were found between groups in goal attainment, global executive function, problem-solving, emotion regulation, and knowledge of how to use the problem-solving and emotion regulation strategies targeted. Experimental group participants rated the application positively, demonstrating feasibility of integration of the app into clinical care. The implementation of SwapMyMood is feasible in a clinical setting. SwapMyMood may be a clinically effective supplemental tool for supporting executive function in SM/Vs with mTBI and co-occurring psychological conditions. Full article