Introduction: Motorized components on power wheelchairs (PWC) enable repositioning to pre-programmed positions (e.g., tilt, leg support, verticalization) to prevent prolonged static positions. Smart technologies can track positioning information and give feedback according to clinical recommendations and personal goals. This study aimed to explore users’ and clinicians’ perceptions of an intelligent dynamic seating (IDS) system prototype comprising a PWC with motorized multi-components connected to a web interface. Methods: A purposive sample of six PWC users and eight clinicians were recruited in this exploratory descriptive qualitative study. Semi-structured interviews included viewing a video of the IDS and images of the web interface. Interviews were transcribed, deductively coded, and thematically analyzed using a conceptual model for evaluating eHealth interventions. Results: Clinicians found the IDS system intuitive to use, customizable, relevant in terms of positioning and clinical recommendations, and timesaving. Powered wheelchair users perceived benefits that could motivate behavioural change, autonomy, health, and inclusion. Concerns related to familiarity with complex technology, funding, cognitive requirements, and technical and health risks were raised. Conclusion: The results inform improvements for the integration of the IDS in clinical practice to respond to the positioning needs of PWC users.

This research aims to enhance the safety and autonomy of powered mobility device (PMD) users through the development of a serious game. Rooted in a co-design and Design Thinking approach, this study highlights the initial phase of the project, which aimed to foster empathy and gain deeper insights into the experiences of PMD users. The study included 42 participants, including users with varying levels of experience with mobility aids as well as professionals from the PMD users ecosystem. Key findings highlighted common errors made by PMD users, such as improper crossing at intersections, exceeding speed limits, using unauthorized accessories on PMD, and neglecting to check blind spots. These behaviors underscored significant gaps in knowledge and practice among users. Participants also perceived notable differences between users with prior driving experience and those without, suggesting that driving background influences behavior and learning needs. This study paves the way for the development of tailored interventions and training tools, such as the proposed serious game, to bridge the identified knowledge gaps and improve the overall safety and autonomy of PMD users.

Introduction: The rapid adoption of telerehabilitation in physiotherapy and occupational therapy has transformed healthcare delivery, offering new opportunities for patient-centered care. However, its implementation raises critical ethical and equity-related questions that require proactive strategies to ensure fair and responsible practices. This review examines how ethical disparities and equity-related challenges are reflected in the existing literature on telerehabilitation. Objective: To investigate the presence of ethical-disparity and equity-related aspects in the provision of telerehabilitation in physiotherapy and occupational therapy as reflected in the literature. Data Sources: A rapid review methodology was employed to explore ethical and equity-related challenges in telerehabilitation. The search included articles published in English and French between 2010 and 2023 from the Medline and Embase databases. Study Selection: Articles were selected based on their relevance to ethical and equity considerations in telerehabilitation. A total of 1750 sources were initially identified, with 67 articles meeting the eligibility criteria for inclusion in this review. Data Extraction: Data were extracted based on variables such as age, gender, ethnicity, morbidity, cost, privacy, confidentiality, and autonomy. The data extraction and analysis were guided by the Progress Plus and Metaverse Equitable Rehabilitation Therapy frameworks. Data Synthesis: The findings were analyzed and discussed using a narrative synthesis approach. The results highlighted key ethical considerations, including adverse events, patient autonomy, and privacy issues. Equity-related aspects were examined, access to rehabilitation services and gender considerations. Disparities in technology access, socioeconomic status, and ethnicity were also identified. Conclusions: This rapid review highlights the growing relevance of ethical and equity considerations in the design and delivery of telerehabilitation within physiotherapy and occupational therapy. The findings show inconsistent reporting and limited depth in addressing key domains such as patient autonomy, privacy, and adverse events, alongside disparities related to age, gender, socioeconomic status, and geographic access. Although telerehabilitation holds promise for expanding access, particularly in underserved areas, this potential remains unevenly realized. The review underscores the critical need for structured, equity-driven, and ethically grounded frameworks such as the Metaverse Equitable Rehabilitation THerapy (MERTH) framework to guide future implementation, research, and policy.

Background/Objective: The most effective strategy for addressing users' prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual's symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users.

The research into and the adoption of telerehabilitation has greatly expanded over the last two decades. With this increasing level of interest in telerehabilitation there is a need for a comprehensive definition. The Telerehabilitation Special Interest Group of the World Federation of Neurorehabilitation is comprised of a diverse group of researchers from over 30 countries and so is well placed to reach a consensus on a definition of telerehabilitation and disseminate this widely. An e-Delphi approach was employed within the special interest group to reach a consensus on the definition. The agreed comprehensive definition of telerehabilitation includes a formal definition, an abbreviated version and a lay version, each with distinct purposes. A description of the scope of telerehabilitation is included, as well as an overview of the various modes of telerehabilitation. It is anticipated that this definition of telerehabilitation may assist researchers, clinicians, advocates and policy makers in a range of purposes.

BACKGROUND:Pedalling on a bicycle is an appropriate rehabilitation intervention which brings complementary information on strength, smoothness, accuracy, and coordination at the lower limbs during movement. This systematic review aims to identify how biomechanical and neuromuscular cycling outcomes inform lower limb sensorimotor function after stroke and to quantify their level of association with clinical measurements. METHODS:The Medline, EMBASE, and CINAHL databases were searched using keywords related to stroke, cycling, and lower limb assessment. The search included original peer-reviewed articles from inception to July 2024 involving adults after stroke for whom cycling was used to evaluate lower limb sensorimotor function. Search, article selection, and data extraction were done by 2 independent reviewers. The risk of bias was assessed with a modified Downs and Black checklist. RESULTS:Fifty-nine articles were included in the review (1290 individuals) with methodological quality ranging from very low 7 % to very high 88 %. High methodological heterogeneity among the articles was observed in cycling modalities and protocols. The articles included >100 different cycling outcomes which can be grouped into kinetic, kinematic, and neuromuscular categories. Psychometric properties of the cycling outcomes were rarely documented (3 articles). Twelve articles reported moderate to very strong significant associations (correlation coefficient values >0.6) of kinetic cycling outcomes with gait (n = 10), balance (n = 6), motricity (n = 8), of kinematic cycling outcomes with motricity (n = 2), and of muscular cycling outcomes with balance (n = 1), and motricity (n = 13). CONCLUSION:The review supports that pedalling on a bicycle provides relevant cycling outcomes which could be useful to complement clinical evaluation in physical rehabilitation. Several kinetic, kinematic, and neuromuscular cycling outcomes are well correlated to lower limb sensorimotor function in individuals after stroke. However, the protocols and clinimetric properties of cycling outcomes require future work. TRIAL REGISTRATION:PROSPERO: CRD42022342113.

PURPOSE:We aimed to describe the development of a tailored, theory-informed training session for an outcome measure (the Mayo-Portland Adaptability Inventory), and evaluate the session's impact on clinician reactions, learning, and behavioural intent. MATERIALS AND METHODS:We developed the training session using an integrated knowledge translation approach with stroke outpatient rehabilitation clinicians in Québec, Canada. We conducted a mixed-method explanatory sequential evaluation informed by the New World Kirkpatrick Model (reaction, learning, behavioural intent) composed of three surveys followed by interviews. We analyzed survey data using cumulative link mixed models, and interviews using directed content analysis. RESULTS:Eighty clinicians attended the training session, of which 51 responded to the surveys and 6 participated in interviews. Odds ratios indicate that individuals were more likely to rate themselves higher post-training on most outcomes. During the interviews, participants indicated that: they experienced positive reactions, learning and behavioural impacts from the session, negative attitudes and commitment were due to perceived limitations in the outcome measure, and training impacts were affected by contextual factors including a provincial mandate for the measure. CONCLUSION:Implementation teams could adapt this training design process to their context. Further research to understand how educational strategies work would produce more robust guidance.

Introduction: The rapid adoption of telerehabilitation in physiotherapy and occupational therapy has transformed healthcare delivery, offering new opportunities for patient-centered care. However, its implementation raises critical ethical and equity-related questions that must be addressed to ensure fair and responsible practices. This review examines how ethical disparities and equity-related challenges are reflected in the existing literature on telerehabilitation. Objective: To investigate the presence of ethical-disparity and equity-related aspects in the provision of telerehabilitation in physiotherapy and occupational therapy as reflected in the literature. Methods: A rapid review methodology was employed to explore ethical and equity-related challenges in telerehabilitation. The search included articles published in English and French between 2010 and 2020 from the Medline and Embase databases. Articles were selected based on their relevance to ethical and equity considerations in telerehabilitation. A total of 1,556 sources were initially identified, with 57 articles meeting the eligibility criteria for inclusion in this review. Data were extracted based on variables such as age, gender, ethnicity, morbidity, cost, privacy, confidentiality, and autonomy. The data extraction and analysis were guided by the Progress Plus and Metaverse Equitable Rehabilitation Therapy frameworks. A narrative synthesis approach was used to analyze and discuss the findings. The results highlighted key ethical considerations, including adverse events, patient autonomy, and privacy issues. Equity-related aspects were examined with a significant focus on age demographics, access to rehabilitation services, and gender considerations. Disparities in technology access, socioeconomic status, and ethnicity were also identified. Conclusions: The review underscores the importance of addressing ethical and equity-related issues in telerehabilitation to ensure a socially just, responsible, and inclusive approach to care. Additionally, it highlights the potential for telerehabilitation to offer personalized interventions that cater to individual patient needs, further advancing equitable and patient-centered rehabilitation practices.

INTRODUCTION:Visiting a patient's living environment is important for occupational therapists, albeit costly and time consuming. MapIt is a mobile app producing a 3D representation of a home with the possibility of taking measurements. The purpose of this study was to explore the utility of a 3D representation of a patient's home for the clinical practice of occupational therapists. METHODS:Case study in which the unit of analysis was the utility of MapIt as defined by ISO 9241-11:2018 and as perceived by occupational therapists in four different occupational therapy clinical settings (Canada). Onsite observations with 10 occupational therapists (and their patients) were triangulated with data from interviews, diaries, and logbooks. Inductive thematic condensation led to emerging conclusions for each clinical setting, fuelling the next case data collection and analysis. Inter-case analysis was corroborated by additional occupational therapists, through crowdsourcing and expert review. RESULTS:Occupational therapists' clinical reasoning was supported by the MapIt app, enhancing and streamlining their work and inducing adjustments to treatment plans. Occupational therapists saw and measured the patient's environment remotely, to better match person-environment-occupation and promote occupational engagement. MapIt's 3D representations were judged useful to communicate between occupational therapists and stakeholders, to educate, allow continuity, optimise resources, minimise the patient's time on a waitlist for homecare, and save time for everyone. DISCUSSION:MapIt allowed occupational therapists who performed home visits to bring a little of the patients' home to their office, whereas occupational therapists without access to the home could see it and take measurements. MapIt's utility was confirmed for practice in clinical settings and for better continuity of care between settings. CONCLUSION:MapIt makes it possible for occupational therapists to 'walk around' the patient's home remotely, but the possibility of measuring environmental elements is a 3D model's true added value over currently used photos or short videos.

Background Telerehabilitation (TR) has emerged as a feasible and promising approach for delivering rehabilitation services remotely, utilizing technology to bridge the gap between healthcare providers and patients. As new modalities of virtual care and health technologies continue to emerge, it is crucial to stay informed about the growing landscape of virtual care to ensure that telehealth service delivery is ethical and equitable, and improves the quality of services and patient outcomes. Objective The primary objective of this article is to present the protocol of a rapid review to examine the equity-related aspects surrounding the implementation of TR. This includes a comprehensive analysis of the ethical dimensions and fairness concerns linked to this practice. Methods A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline and EMBASE databases were searched between January 2010 and March 2023. Study selection and data extraction will be conducted in two phases (Phase I) by two independent reviewers and subsequently (Phase II) by a single reviewer. Our study will utilize the PROGRESS-Plus and Equitable virtual rehabilitation in the metaverse era framework to identify dimensions where potential inequities may exist within TR interventions. Results This rapid review is anticipated to enhance our knowledge of TR in the fields of physiotherapy and occupational therapy, with a specific focus on its influence on ethical and equitable practices and providing a foundation for informed decision-making and improved patient care. Conclusion This rapid review will contribute to the advancement of our understanding of TR within physiotherapy and occupational therapy. Through synthesizing existing evidence, this study not only addresses current gaps in knowledge but also offers valuable insights for future research and clinical practice in TR services.

Background:Stationary bikes are used in numerous rehabilitation settings, with most offering limited functionalities and types of training. Smart technologies, such as artificial intelligence and robotics, bring new possibilities to achieve rehabilitation goals. However, it is important that these technologies meet the needs of users in order to improve their adoption in current practice. Objective:This study aimed to collect professionals' perspectives on the use of smart stationary bikes in rehabilitation. Methods:Twelve health professionals (age: mean 43.4, SD 10.1 years) completed an online questionnaire and participated in a semistructured interview regarding their needs and expectations before and after a 30-minute session with a smart bike prototype. Results:A content analysis was performed with inductive coding. Seven main themes emerged: (1) bike functionalities (cycling assistance, asymmetric resistance, and forward and backward cycling), (2) interface between bike and users (simple, user-friendly, personalized, with written reminders during training), (3) feedback to users (user and performance data), (4) training programs (preprogrammed and personalized, and algorithmic programs), (5) user engagement (telerehabilitation, group sessions, music, and automatic suggestion of training), (6) the bike as a physical device (dimensions, comfort, setup, screen, etc), and (7) business model (various pricing strategies, training for professionals, and after-sales service). Conclusions:This study provides an interpretive understanding of professionals' perspectives regarding smart stationary bikes and is the first to identify the expectations of health professionals regarding the development of future bikes in rehabilitation.

Assistive technology (AT) is crucial for aiding activities of daily living in individuals with visual impairment; yet, without systematic follow-up device abandonment rates remain high. This scoping review synthesizes existing literature on follow-up processes in individuals with visual impairment undergoing vision rehabilitation with AT. Employing the Arksey and O'Malley framework, this review comprehensively searched seven databases, identifying 1,061 articles, of which 43 were selected for analysis, using the concepts of visual impairment, rehabilitation, and assistive technology. The publications span from 1989 to 2022. Most studies (n = 36, 83%) utilized a mixed-methods design, and 51% (n = 22) originated from the United States. Devices for near vision were the most commonly prescribed type of AT. Follow-up methods included questionnaires and interviews, with most follow-ups conducted at the client's home. Follow-up timing varied across studies, whereby 37% (n = 16) occurred after one or more years and 33% (n = 14) between one week and four months. Three categories of outcome measures emerged: generic outcomes, task-specific outcomes, and a combination of both. The review identified several gaps in the literature, including a scarcity of research concerning follow-up of AT particularly for both the type and timing of follow-up.

Adherence to home-based rehabilitation exercises is a challenge for individuals with chronic neurological conditions. Socially assistive robots are becoming an option to resolve compliance challenges with rehabilitation exercises. An in-depth exploration of how natural human-robot interaction could help improve adherence to home-based rehabilitation exercises is justified. The first study objective was to explore how a robot that offers supervision and encouragement could increase adherence to home-based long-term rehabilitation exercises for individuals with neurological conditions. The second objective was to explore perceived obstacles and facilitators related to using a robot with artificial audition capabilities. These results will be used to guide the design and optimization of robot audition technology within a larger research program. Six focus groups were held to elicit the views of individuals with neurological conditions (n=3 groups) and health care professionals (n=3 groups). Content was analyzed qualitatively. Four topics were addressed during the focus groups: challenges in performing exercises, needs to be met by the technology, desired technological characteristics and anticipated impacts. Our results identified different needs, characteristics and anticipated limitations as preliminary key items to guide a user-centered design. Participants were generally positive about the concept of using socially and technically assistive robotic technology to meet the home-based exercise needs of people with neurological conditions. Health care professionals, however, anticipated more limitations than clients.

L’accident vasculaire cérébral (AVC) peut entraîner des déficiences de la fonction sensorimotrice avec des conséquences sur la participation sociale et la qualité de vie [1], [2]. En plus des évaluations cliniques standardisées, la marche informe sur les capacités des membres inférieurs, mais est limitée aux personnes ambulantes. À l’inverse, le pédalage, une activité qui partage des patrons de mouvements et d’activité musculaire communs avec la marche [3], peut être utilisé pour informer sur la fonction sensorimotrice même chez des personnes rencontrant des difficultés à la marche [4]. Cependant, peu d’évidences existent pour appuyer son utilisation. L’objectif de cette revue systématique était d’identifier les paramètres d’évaluation du pédalage et les protocoles utilisés afin d’en recommander l’utilisation pour caractériser la fonction sensorimotrice des personnes post-AVC. Le protocole de la revue a été publié sur PROSPERO (CRD42022342113). Trois bases de données (CINAHL, Embase, Medline) ont été consultées le 3 mai 2022 en utilisant les mots clés et descripteurs liés à la population (personnes post-AVC), le pédalage et l’évaluation des membres inférieurs. Au total, 1266 articles ont été retrouvés et après avoir retiré les doublons, 854 articles ont été examinés pour l’éligibilité par deux relecteurs. Les conflits d’intérêts ont été extraits et les risques de biais des articles inclus ont été évalués par deux relecteurs. La revue a été en partie financée par le programme MITACS Accélération (J. Soulard) et le REPAR (R. Walha). Les premières analyses révèlent que les protocoles expérimentaux (matériel utilisé, modes et durée de pédalage) sont très hétérogènes entre les études. Les paramètres cinétiques (vitesse, force, puissance, asymétrie, travail mécanique), cinématiques (amplitudes de mouvement) et musculaires (RMS, IEMG, % de valeur maximale, timing d’activation et synergies) sont les plus fréquents pour caractériser la fonction sensorimotrice des membres inférieurs lors du pédalage. En général, les qualités psychométriques des paramètres ont été peu étudiées. Certains paramètres sont corrélés à la fonction motrice, la force musculaire ou aux activités fonctionnelles (marche, escaliers). Nous continuons les analyses, entre autres, pour identifier les paramètres et protocoles les plus pertinents pour caractériser la fonction sensorimotrice lors du pédalage afin de proposer une batterie d’évaluation aux cliniciens pour la rééducation des personnes post-AVC.

IntroductionStroke is a leading cause of morbidity and mortality worldwide, placing an immense burden on patients and the health system. Timely access to rehabilitation services can improve stroke survivors' quality of life. The use of standardised outcome measures is endorsed for optimising patient rehabilitation outcomes and improving clinical decision-making. This project results from a provincially mandated recommendation to use the fourth version of the Mayo-Portland Adaptability Inventory (MPAI-4) to measure changes in social participation of stroke survivors and to maintain commitment to evidence-informed practices in stroke care. This protocol outlines the implementation process of the MPAI-4 for three rehabilitation centres. The objectives are to: (a) describe the context of MPAI-4 implementation; (b) determine clinical teams' readiness for change; (c) identify barriers and enablers to implementing the MPAI-4 and match the implementation strategies; (d) evaluate the MPAI-4 implementation outcomes including the degree of integration of the MPAI-4 into clinical practice and (e) explore participants' experiences using the MPAI-4.Methods and analysisWe will use a multiple case study design within an integrated knowledge translation (iKT) approach with active engagement from key informants. Each case is a rehabilitation centre implementing MPAI-4. We will collect data from clinicians and programme managers using mixed methods guided by several theoretical frameworks. Data sources include surveys, focus groups and patient charts. We will conduct descriptive, correlational and content analyses. Ultimately, we will analyse, integrate data from qualitative and quantitative components and report them within and across participating sites. Results will provide insights about iKT within stroke rehabilitation settings that could be applied to future research projects.Ethics and disseminationThe project received Institutional Review Board approval from the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal. We will disseminate results in peer-reviewed publications and at local, national and international scientific conferences.

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors—education/research, practice, and policy/regulation—that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector’s individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants’ conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners’ effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.