Rehabilitation clinicians’ use of mainstream wireless technologies in practice: a scoping review

Abstract

Purpose

This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use.

Materials and methods

This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015–2022 were retrieved.

Results

A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated.

Conclusion

MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels.

Implications For Rehabilitation

• A total of 90 articles from 2015–2022 were included in this scoping review

• Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills.

• An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice.

• Clinicians’ education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed.

• This review also discusses implications of findings on policy, technology development, and future research.

Keywords:

• Aged
• rehabilitation
• telerehabilitation
• wireless technology
• mobile applications
• smartphone
• wearable electronic devices
• disabled persons
• frail elderly

Acknowledgements

The content is solely the responsibility of the authors and does not represent the official views of the NIDILRR and ACL. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. We would like to thank Ricardo Ayala Jiménez, MD; Eric Weidert, DO; Jessica Boateng, MPH; and Lynn Worobey, PhD for assistance with this scoping review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this publication was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), the Administration for Community Living (ACL) under the award number 90REGE0016. The content is solely the responsibility of the authors and does not represent the official views of the NIDILRR and ACL. This material is the result of work supported with resources and the use of facilities at the VA Pittsburgh Healthcare System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

Notes on contributors

Brad E. Dicianno

Brad E. Dicianno MD is a physiatrist and bioengineer. He is a Professor and Endowed Research Chair in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh School of Medicine. He serves as the Medical Director and COO of the Human Engineering Research Laboratories at the VA Pittsburgh Healthcare System. He is the Medical Director of the UPMC Center for Assistive Technology and the Director of the UPMC Adult Spina Bifida Clinic. His clinical interests are in the areas of spina bifida and assistive technology. His research interests lie at the intersection of disability, assistive technology, and value-based care. Specifically, he is interested in studying how technologies can improve outcomes for people with disability and also improve the delivery of healthcare and community-based services. Relevant technologies are mobile health, telemedicine, electronic medical records interoperability, and rehabilitation engineering devices such as wheelchairs. He is the Co-Director of the Rehabilitation Engineering Research Center (RERC) on Wireless Technology for People with Disabilities.

Angad Salh

Angad Salh is enrolled in the Doctorate of Osteopathy program at Kansas City University.

Lindsey Morris

Lindsey Morris, OTD, OTR/L is a clinical research scientist in the Department of Rehabilitation Science and Technology at the University of Pittsburgh. She began her career in the non-profit sector serving as the director of Programming for the Down Syndrome Association of the Valley where she led a diverse range of advocacy, educational outreach, support, and occupation-based programs. This experience sparked her interest in research and community-based programs to support occupational participation and health of persons with disabilities, which led her to pursue a doctorate of occupational therapy from MGH Institute of Health Professions. Her research interests focus on supporting use of mainstream smart technologies as everyday and assistive technologies in occupation and community-based interventions to improve the health, participation and quality of life of persons with disabilities and underserved populations.

Yifan Xiang

Yifan Xiang is a freshman undergraduate student at the University of Pittsburgh.

Dan Ding

Dan Ding is Associate Professor and Vice Chair for Research in the Department of Rehabilitation Science and Technology at the University of Pittsburgh. She is also a Research Biomedical Engineer within the VA Pittsburgh Healthcare System. The common threads running through her research are related to her interests in sensors, machine learning, and human-machine interaction. Through her research, she seeks opportunities to apply knowledge from these fields to assistive devices and systems for people with disabilities. She has been particularly active in the areas of using smart technology (i.e., wearables, internet-of-things, and assistive robotics) to support health/wellness, independence, and participation of people with disabilities. She is the Director of the Rehabilitation Engineering Research Center (RERC) on Wireless Technology for People with Disabilities.