Dual task (DT) assessments evaluating walking combined with a cognitive task are valuable tools for testing functional capacity and monitoring age-related decline. Despite this, motor-cognitive DT assessments are underutilised in clinical practice. This has been attributed in part to methodological challenges, including heterogeneity in DT measurement protocols and poor reliability of outcome measures. To address these barriers, this scoping review systematically identified motor-cognitive DT walking assessments used with healthy older adults and examined current practice in reporting and standardisation. The purpose was to inform the refinement of DT assessments to enhance their precision and reproducibility, facilitating their future integration into routine clinical practice. A systematic search of five electronic databases identified studies that investigated motor-cognitive DT walking assessments in community-dwelling, cognitively healthy older adults. The reporting and standardisation of measurement procedures was extracted using the COSMIN framework. The findings were analysed descriptively. The review included 38 studies investigating a walking motor task combined with a variety of cognitive tasks. The most common walking tasks were unidirectional gait, the timed up and go (TUG), or walking and turning tasks. The most prevalent cognitive tasks included serial subtraction, animal naming, and reciting alternate alphabet letters. There was substantial variability in the administration of DT assessments and no studies fully reported the procedures for set up, test performance, and data collection. Of particular concern was the poor reporting of general task instructions, task prioritisation, and practice trials. The review identified a lack of standardisation in DT walking measurement procedures, which likely contributes to measurement variability and limits clinical replication. Given that measurement variability inherent in single task assessments is compounded when motor and cognitive tasks are combined, it is critical to address these sources of inconsistency to ensure DT measures detect and accurately reflect true performance changes. Recommendations are made to improve standardisation of DT measurements with the aim of facilitating their broader adoption and implementation in clinical practice.

Physical exercise is known to delay the cognitive decline in the elderly. However, the effect of low-impact balance exercises such as yoga or Tai chi has not been explored in detail. This cross-sectional observational study used brain magnetic resonance imaging data to quantify and compare various brain structures between neurologically healthy adults aged between 55 and 65, divided into Control Group and Balance Exercise (BE) Group based on the self-reported balance exercise status. Various brain attributes such as brain age, cortical and subcortical volume, thickness, surface area, and mean curvature were extracted and computed using machine learning algorithm software like brainageR and FreeSurfer. Clinical functional assessments (balance, vestibular and cognitive measures) were also conducted for the participants. Statistical analyses were performed to determine any differences between the groups at a significance level of 5%. The BE group showed statistically significantly higher values for the right caudal anterior cingulate thickness, left and right superior temporal volume, left entorhinal volume and mean curvature, left frontal pole thickness, left superior temporal area and left inferior temporal thickness. A statistically significant cluster after correction for multiple comparisons was found in the left rostral middle frontal gyrus with a higher volume for BE group. Clinical functional assessments (balance, vestibular and cognitive) and brain age differences were nonsignificant. The significant brain regions in the BE group are involved in memory, cognition, focus, planning, language and auditory processing, decision making, emotional regulation and mental health and could be responsible for protecting and delaying the cognitive declines in the elderly.

Background Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%). Results Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.80 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%). Conclusion The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.

Background: Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method: Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure (SEM). Results: When the mean of three trials was analysed, there was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92-0.99]), moderate reliability for TA EMG (ICC 0.86 [0.60-0.96]) and time to reach 90% MVC (ICC 0.8 [0.53-0.93]) and poor reliability for dorsiflexor RFD200ms (ICC 0.79 [0.48-0.92]). Conclusion: Given the functional significance of the ankle dorsiflexors, future research should investigate more reliable methods for measuring rapid force production in the dorsiflexor muscles after stroke.

BACKGROUND AND PURPOSE:Augmented reality (AR) and artificial intelligence (AI) have been applied to the assessment and rehabilitation of post-stroke spatial neglect (SN). This study aims to evaluate the feasibility, effectiveness, degree of personalization, and ecological validity of AR, AI, and hybrid methods for SN assessment and rehabilitation. METHODS:PubMed, Scopus, Web of Science, Embase, CINAHL, IEEE Xplore, and the ACM Digital Library were searched up to August 2025. Two reviewers independently screened articles, extracted data, and assessed risk of bias and outcome-level certainty. RESULTS:Of 268 screened studies published between 2000 and 2025, 15 met the inclusion criteria, including 11 assessment studies (8 AI, 1 AR, and 2 hybrid) and 4 AR rehabilitation studies, involving 567 participants. AI assessment methods demonstrated high diagnostic accuracy (area under the curve (AUC) up to 0.95), and 1 AR assessment showed strong diagnostic accuracy (AUC = 0.89). Four AR rehabilitation studies reported acceptable feasibility, with 1 randomized controlled trial (RCT) showing improvements in several neglect outcomes. Ecological validity and personalization were generally very low, and the overall certainty of evidence ranged from low to very low. CONCLUSION:Current evidence for AR and AI SN assessment and rehabilitation methods remains insufficient to determine their feasibility, effectiveness, ecological validity, and degree of personalization, largely due to small sample sizes, methodological heterogeneity, and the limited number of RCTs. Future research should focus on developing standardized, scalable frameworks that integrate AR with adaptive AI models, and multicenter RCTs are required to confirm clinical efficacy and long-term functional outcomes.

Recent evidence points to the effect of chronotropic incompetence (CI), which refers to a blunted heart rate (HR) response to exercise, influencing physiological outcomes in people with Parkinson’s disease (PD). This study explores the effect of CI on physiological responses and examines whether a high-intensity training zone is attained during non-contact boxing training in people with PD. In total, 11 PD participants with CI (PDCI), 13 without CI (PD non-CI), and 14 age-matched controls performed two non-contact boxing sessions on different days. The primary outcomes were the maximum HR (HRmax), average HR (HRavg), percentage of the highest HR from cardiopulmonary exercise test (%HR-CPET) and predicted maximum HR (%MA-PHR), time exercising above 85%HRmax (HI-85%), and second ventilatory threshold (HI-VT2). PDCI participants displayed significantly lower HRavg and HRmax values during all rounds than PD non-CI participants and controls for both sessions (p ≤ 0.001). No significant differences were observed between PD non-CI participants and controls (p ≥ 0.05). Although all participants exercised at approximately 100% of %HR-CPET, PDCI participants showed a significantly lower %MA-PHR than PD non-CI participants and controls (p ≤ 0.001). HI-85% and HI-VT2 were not significantly different between PDCI and PD non-CI participants. Despite exhibiting a lower absolute HRmax and HRavg during boxing compared to PD non-CI participants and aged-match controls, PDCI participants exercise at a similar intensity within the high-intensity training zone when expressed as a percentage of the individualized HRmax.

Background: Rehabilitation is vital for optimizing recovery following neurological injuries. However, much of what is done for the paediatric population relies heavily on the adult literature or is based on expert opinion. No previous attempt has been made to collate high-quality evidence pertaining to the subacute period. Objectives: To summarize and appraise the evidence from systematic reviews regarding the efficacy of inpatient neurorehabilitation interventions for paediatric patients in the 6 months immediately following neurological injury. Method: A systematic search was conducted of PubMed, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, and Cochrane databases, as well as using Google Scholar. Selection required an appraisal of efficacy of an inpatient rehabilitation intervention delivered within 6 months of injury. Results: 1,250 papers were found. Titles and abstracts were compared against the selection criteria, with 52 papers being selected for full-text review. None of these met the selection criteria. Exclusions were often due to setting and chronicity. Conclusions: This review reveals a critical lack of systematically reviewed evidence within the scope investigated. There is a pressing need for evaluation of current interventions. In the future, alternative approaches to identifying and appraising different forms of available evidence could be considered.

INTRODUCTION:Telerehabilitation offers the potential to improve access to specialty rehabilitation for people with mild traumatic brain injury (mTBI) and reduce health disparities for those living in geographically rural/remote areas. The success of telerehabilitation depends on the extent to which the service meets the patient's needs and their ability to access the services remotely. AIM:This study aims to help Healthcare practitioners and government agencies develop effective and patient-centred telerehabilitation services for mTBI patients. METHODS:Participants were mTBI survivors or close acquaintances of a mTBI patient. The survey involved asking participants to choose between hypothetical rehabilitation scenarios with varying attributes, including the session duration (long or short), location (clinic-based vs telerehabilitation), therapist involvement, inclusion of online resources, associated cost and community COVID-19 threats. RESULTS:The results suggest that there was a preference for rehabilitation rather than no rehabilitation, with an overall preference for long telerehabilitation sessions. The results differed somewhat between the groups, with people living with a mTBI being more positive towards clinic-based sessions and less impacted by the threat of COVID-19. The results are consistent with the proposition that individuals prefer telerehabilitation appointments. Although preferences differed between groups, the preference for telerehabilitation persisted, driven by time and cost considerations associated with in-person visits. DISCUSSION:The findings suggest that mTBI patients value rehabilitation services, and that Healthcare practitioners and government agencies should consider offering long telerehabilitation sessions. Further research is warranted to assess the efficacy and feasibility of implementing telerehabilitation programs in clinical settings for mTBI patients.

BACKGROUND:Unilateral nostril breathing (UNB) has a history linked to ancient yogic traditions where it is believed to affect both physical and mental states however the mechanism(s) by which this technique potentially influences brain electrical activity remains poorly explored. METHODS:In this pilot study we investigated the influence of pressurised device-regulated UNB on brain functional network activity in healthy awake individuals to test its suitability for later use in hypothesis-driven clinical trials. Baseline bilateral EEG data were acquired, and then dominant/nondominant nostril UNB protocols were used to assess changes in brain network functional connectivity signal coherence, and phase lag index. RESULTS:Changes in functional connectivity were detected only when comparing right to left UNB, with the following networks demonstrating changes: the Default Mode Network which included reduced alpha and increased beta wave activity; the Salience Network, which included increased gamma wave activity; the Auditory Network, which included increased gamma and delta wave activity; and the Left Brain Region, which included reduced delta wave activity. CONCLUSIONS:This study revealed that device-regulated pressurised left/right UNB changed brain FC in awake healthy individuals in several brain networks. Nasal cycle dominance was found to play no role in UNB influencing brain FC; rather, nasal morphology (left/right side) seems to be the controlling factor. Further investigations are needed to verify our results and apply them to clinical populations.

An established aspect of noisy galvanic vestibular stimulation (nGVS) is tuning the nGVS signal to optimize stability on an individual basis. However, conventional tuning methods are strongly influenced by historical approaches and fail to integrate contemporary research findings. We outline a process used to integrate current physiological and neuroscientific insights into a robust method for personalizing nGVS signals to improve stability. We argue that an optimization protocol for a neuromodulatory nGVS signal designed to facilitate postural control needs to include: (1) A task that is relevant to the population, and which can be modified to give an appropriate level of challenge at an individual level; (2) Elements that can be reliably measured and are responsive to changes in postural control; (3) Well controlled and defined signal parameters; (4) Potential to be translated into the clinical setting. Questioning conventional methods enabled us to develop an alternative nGVS optimization assessment to enhance postural control in people with bilateral vestibulopathy. Refining this optimization assessment represents a crucial step in developing individualized nGVS interventions. The fundamental principles applied to develop our method can be adapted to other neuromodulatory stimuli across different impairments and populations.

ObjectivesRehabilitation is essential for supporting the recovery from, and management of, a range of health conditions. However, interventions are often poorly reported in rehabilitation research, hindering advancement of the field. The Template for Intervention Description and Replication (TIDieR) checklist was developed to enhance the reporting of interventions, but does not specifically address the complexities and multifaceted nature of rehabilitation interventions. This study aimed to develop an extension of the TIDieR checklist to support better reporting of rehabilitation interventions.DesignA modified Delphi study overseen by a Steering Committee.SettingOnline.ParticipantsRehabilitation experts were purposively sampled for diversity in discipline, practice setting, area of expertise and geographical location.MethodsParticipants (n=35) provided both quantitative and qualitative feedback on drafts of the TIDieR-Rehab through online surveys. Quantitative data was descriptively analysed by percentage of agreement, while qualitative data was analysed using conventional content analysis. Quantitative and qualitative findings were subsequently triangulated to facilitate iterative refinement of the TIDieR-Rehab.ResultsConsensus was achieved after two rounds of the modified Delphi process. The TIDieR-Rehab checklist comprises seven original, three adapted and 12 new reporting items, and is supported by a supplementary manual. Specific enhancements include more detailed descriptions of the study population (Who) and timing of the intervention (When), the planned intervention dosage (How much,How challengingandRegression/Progression), person-centred care (Personalisation) and negative undesired effects (Harms) which were considered critical for the comprehensive reporting of rehabilitation interventions.ConclusionThe TIDieR-Rehab checklist marks a significant advancement in enhancing and standardising the reporting of rehabilitation interventions. By offering a structured format for detailing complex rehabilitation interventions, the TIDieR-Rehab supports improvements in reporting quality to promote research replication and support the translation of research findings into clinical practice. Future research should validate the TIDieR-Rehab checklist across a variety of intervention types and clinical contexts.

Heart rate (HR) response is likely to vary in people with Parkinson’s disease (PD), particularly for those with chronotropic incompetence (CI). This study explores the impact of CI on HR and metabolic responses during cardiopulmonary exercise test (CPET) in people with PD, and its implications for exercise intensity prescription. Twenty-eight participants with mild PD and seventeen healthy controls underwent CPET to identify the presence or absence of CI. HR and metabolic responses were measured at submaximal (first (VT1) and second (VT2) ventilatory thresholds), and at peak exercise. Main outcome measures were HR, oxygen consumption (VO2), and changes in HR responses (HR/WR slope) to an increase in exercise demand. CI was present in 13 (46

PURPOSE:This study aimed to determine if the Promoting Optimal Physical Exercise for Life (PROPEL) program increases participation in physical activity up to six months post-discharge from stroke rehabilitation, compared to participation in group cardiorespiratory exercise (GCE) alone. METHODS:This was a stepped-wedge cluster superiority randomised controlled trial. People with sub-acute stroke participated in the PROPEL (n = 107) or GCE (n = 65) intervention phases. The primary outcome was adherence to physical activity guidelines over seven days at six months post-discharge from rehabilitation. Secondary outcomes were exercise self-efficacy (Short Self-Efficacy for Exercise scale), exercise-related beliefs and attitudes (Short Outcome Expectation for Exercise scale), and perceived barriers to physical activity (Barriers to Being Active Quiz). RESULTS:Fifty-seven participants (PROPEL, n = 29; GCE, n = 28) were included in the analysis. At six months post-discharge, 6/17 PROPEL participants and 9/22 GCE participants met the guidelines for intensity and duration of physical activity; the odds of meeting physical activity guidelines did not differ between phases (p > 0.84). PROPEL participants reported higher self-efficacy for exercise than GCE participants (p = 0.0047). CONCLUSIONS:While PROPEL participants reported higher self-efficacy for exercise than those who completed GCE alone, we were unable to find evidence that this translated to increased odds of meeting physical activity guidelines. TRIAL REGISTRATION:NCT02951338IMPLICATIONS FOR REHABILITATIONIntegration of cardiorespiratory exercise with behaviour modification strategies to improve physical activity participation after discharge from stroke rehabilitation increases self-efficacy for exercise when compared to cardiorespiratory exercise alone.Increased self-efficacy for exercise may not increase the odds of meeting physical activity guidelines post-stroke.Improving self-efficacy for exercise during stroke rehabilitation may encourage participation in moderate to vigorous physical activity up to 6-months post-discharge from rehabilitation.

Smartphone accelerometry has potential to provide clinicians with specialized gait analysis not available in most clinical settings. The Gait&Balance Application (G&B App) uses smartphone accelerometry to assess spatiotemporal gait parameters under two conditions: walking looking straight ahead and walking with horizontal head turns. This study investigated the validity of G&B App gait parameters compared with the GAITRite (R) pressure-sensitive walkway. Healthy young and older adults (age range 21-85 years) attended a single session where a smartphone was secured over the lumbosacral junction. Data were collected concurrently with the app and GAITRite (R) systems as participants completed the two walking conditions. Spatiotemporal gait parameters for 54 participants were determined from both systems and agreement evaluated with partial Pearson's correlation coefficients and limits of agreement. The results demonstrated moderate to excellent validity for G&B App measures of step time (r(p) 0.97, 95 % CI [0.96, 0.98]), walking speed (r(p) 0.83 [0.78, 0.87]), and step length (r(p) 0.74, [0.66, 0.80]) when walking looking straight ahead, and results were comparable with head turns. The validity of walking speed and step length measures was influenced by sex and height. G&B App measures of step length variability, step time variability, step length asymmetry, and step time asymmetry had poor validity. The G&B App has potential to provide valid measures of unilateral and bilateral step time, unilateral and bilateral step length, and walking speed, under two walking conditions in healthy young and older adults. Further research should validate this tool in clinical conditions and optimise the algorithm for demographic characteristics.

AIM:We aimed to explore participant perspectives on social prescribing (SP) for mental health and well-being and the acceptability of community pharmacists (CP) as members of SP pathways that support people with mild to moderate depression and anxiety. BACKGROUND:SP aims to support people with poor health related to socio-demographic determinants. Positive effects of SP on self-belief, mood, well-being, and health are well documented, including a return to work for long-term unemployed. METHODS:The study was set in a city in southwest England with diverse cultural and socio-demographics. We recruited SP stakeholders, including CP, to either one of 17 interviews or a focus group with nine members of the public. FINDINGS:An inductive iterative approach to thematic analysis produced four superordinate themes: (1) offering choice a non-pharmacological option, (2) supporting pharmacy communities - 'it is an extension of what we do', (3) stakeholder perspectives - pharmacists are very busy and their expertise unknown by some, and (4) potential for pharmacy in primary care.Stakeholders viewed CP as local to and accessible by their community. Pharmacists perceived referral to SP services as part of their current role. General practitioner participants considered pharmacy involvement could reduce their workload and expand the primary healthcare team. Importantly, general practitioners and CP viewed SP as a non-pharmacological alternative to prescribing unnecessary antidepressants and reduce associated adverse effects. All participants voiced concerns about pharmacy dispensing busyness as a potential barrier to involvement and pharmacists requesting mental health training updates.Key findings suggest CP offer a potential alternative to the general practitioner for people with mild to moderate depression and anxiety seeking access to support and health information. However, CP need appropriately commissioned and funded involvement in SP, including backfill for ongoing dispensing, medicines optimization, and mental health first aid training.

Aerobic training is popular for people with Parkinson’s disease (PD) given its potential to improve aerobic capacity, relieve symptoms, and to stabilise disease progression. Although current evidence supports some of the assertions surrounding this view, the effect of exercise intensity on PD is currently unclear. Reasons for this include inconsistent reporting of exercise intensity, training regimes based on general guidelines rather than individualised physiological markers, poor correspondence between intended exercise intensities and training zones, and lack of awareness of autonomic disturbance in PD and its impact on training regimes and outcome. We also consider the selective effect of exercise intensity on motor symptoms, function and disease progression. We review aerobic training protocols and recent guidelines for people with PD, highlighting their limitations. Considering this, we make suggestions for a more selective and discerning approach to aerobic training programming.

Background Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%). Results Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.8 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%). Conclusion The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.

This study investigates how adding a cognitive task on a balance board (exergame) affects connectivity in the dorsal attention network (DAN) during an exergame task. Healthy young adults performed a soccer ball-moving task by tilting a balance board with their feet while their brain activity was measured using electroencephalography (EEG). In this exergame, the speed of obstacles in front of the goal manipulated the cognitive workload. Higher speed means a higher cognitive workload. The study found significant changes in functional connectivity within DAN regions, specifically in the alpha band. During the shift from easy to medium cognitive task, we observed a significant increase in connectivity (p= 0.0436) between the right inferior temporal (ITG R) and the Left middle temporal (MTG L). During the transition from easy to hard cognitive tasks, strengthened interactions (p= 0.0324) between inferior temporal (ITG) and parsopercularis (pOPPER) were found. This suggests that the proposed balanceboard-based exergame enhances the functionality of specific brain regions, such as ITG and MTG regions, and improves connectivity in the frontal cortex. We also found a correlation between brain activity and performance data, highlighting that increased cognitive workload resulted in decreased performance and heightened frontal alpha activity. These findings align with research suggesting that adding cognitive games to physical activity-based tasks in rehabilitation programs can boost brain activity, resulting in improved decision-making and visual processing skills. This information can help clinicians tailor rehabilitation methods that target specific brain regions.

Background Usability has been touted as one determiner of success of mobile health (mHealth) interventions. Multiple systematic reviews of usability assessment approaches for different mHealth solutions for physical rehabilitation are available. However, there is a lack of synthesis in this portion of the literature, which results in clinicians and developers devoting a significant amount of time and effort in analyzing and summarizing a large body of systematic reviews. Objective This study aims to summarize systematic reviews examining usability assessment instruments, or measurements tools, in mHealth interventions including physical rehabilitation. Methods An umbrella review was conducted according to a published registered protocol. A topic-based search of PubMed, Cochrane, IEEE Xplore, Epistemonikos, Web of Science, and CINAHL Complete was conducted from January 2015 to April 2023 for systematic reviews investigating usability assessment instruments in mHealth interventions including physical exercise rehabilitation. Eligibility screening included date, language, participant, and article type. Data extraction and assessment of the methodological quality (AMSTAR 2 [A Measurement Tool to Assess Systematic Reviews 2]) was completed and tabulated for synthesis. Results A total of 12 systematic reviews were included, of which 3 (25%) did not refer to any theoretical usability framework and the remaining (n=9, 75%) most commonly referenced the ISO framework. The sample referenced a total of 32 usability assessment instruments and 66 custom-made, as well as hybrid, instruments. Information on psychometric properties was included for 9 (28%) instruments with satisfactory internal consistency and structural validity. A lack of reliability, responsiveness, and cross-cultural validity data was found. The methodological quality of the systematic reviews was limited, with 8 (67%) studies displaying 2 or more critical weaknesses. Conclusions There is significant diversity in the usability assessment of mHealth for rehabilitation, and a link to theoretical models is often lacking. There is widespread use of custom-made instruments, and preexisting instruments often do not display sufficient psychometric strength. As a result, existing mHealth usability evaluations are difficult to compare. It is proposed that multimethod usability assessment is used and that, in the selection of usability assessment instruments, there is a focus on explicit reference to their theoretical underpinning and acceptable psychometric properties. This could be facilitated by a closer collaboration between researchers, developers, and clinicians throughout the phases of mHealth tool development. Trial Registration PROSPERO CRD42022338785; https://www.crd.york.ac.uk/prospero/#recordDetails