Technologies in home-based digital rehabilitation: A scoping review (Preprint)

Abstract

Due to population growth, aging, and the increasing number of people with chronic diseases and disabilities, the need for rehabilitation is steadily increasing worldwide and though the pressure on the health care system is rising. Therefore, a shift in rehabilitation to the home setting is essential. For effective home-based rehabilitation, sufficient support must be provided. New digital technologies could help to meet these demands. The COVID-19 pandemic has further exacerbated the challenges on the health care system faced by affected individuals during rehabilitation. To develop and implement digital rehabilitation solutions that meet the clients’ need and ease the growing pressure on the healthcare system it is necessary to give an overview of existing, relevant and future solutions shaping the constantly evolving market of technologies for home-based digital rehabilitation.

The scoping review aims to identify digital technologies for home-based rehabilitation, to predict emerging trends in digital rehabilitation, and to report the influences of the COVID-19 pandemic on digital rehabilitation.

A scoping review following the framework of Arksey and O’Malley with the improvements of Levac and colleagues were carried out. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Cochrane library. The search spanned from January 2015 to January 2022. Every type of English written publication that was existing as full-text and focuses on digital technologies directly related to home-based rehabilitation were included. A bibliometric analysis was performed to give an overview of the included references. A co-occurrence analysis was carried out to identify the technologies for home-based digital rehabilitation. A full-text-analysis of all included reviews was conducted to filter the trends for the home-based digital rehabilitation. A grey literature search was carried out to adjunct the results of the review analysis and to reveal the influences of the COVID-19 pandemic regarding the development of digital rehabilitation.

A total of 2.437 records was included for the bibliometric analysis, 95 for full-text-analysis and 42 as a result of the grey literature search. Sensors, robotic devices, gamification, virtual and augmented reality (VR/AR), and digital/mobile applications are already widely used in home-based rehabilitation, but AI/machine learning, exoskeletons, and mobile/digital applications represent emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches, however not to the development of new technologies.

Multiple tools are available and implemented for home-based rehabilitation. AI and machine learning will be part of particular interest for the redesign of rehabilitation to address future challenges of the rehabilitation sector. The results reflect the need for feasible approaches to implement digital rehabilitation that meet clients’ needs and adhere to framework conditions to be sustained apart from exceptional situations.