Background Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients’ needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. Objective In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. Methods The scoping review followed the framework of Arksey and O’Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. Results A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and 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 but has not led to the development of new technologies. Conclusions Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients’ needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.

IntroductionOsteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially combined with in-person sessions seems to be promising. Therefore, the aim of this study was to investigate the needs, preconditions, barriers and facilitators of blended physical therapy.MethodsThis Delphi study consisted of interviews, an online survey and focus groups. Participants were physical therapists, patients with hip or knee osteoarthritis with or without experience in digital care and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the “Consolidated Framework For Implementation Research”. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators and barriers were discussed. In the second phase, an online survey and focus groups served the process to confirm the needs and collect preconditions.ResultsNine physical therapists, seven patients and six stakeholders confirm that an increase of acceptance of digital care by physical therapists and patients is crucial. One of the most frequently mentioned facilitator was conducting regular in-person sessions. Physical therapists and patients conclude that blended physical therapy needs to be tailored to the patients’ needs. The reimbursement of blended physical therapy needs to be clarified.DiscussionMost importantly, it is necessary to strengthen the acceptance of patients and physical therapists towards digital care. Overall, for development and implementation purposes, it is crucial to take the needs and preconditions into account.

Background Osteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially when combined with in-person sessions, seem to be promising. Objective The aim of this study was to investigate the needs, preconditions, barriers, and facilitators of blended physical therapy for osteoarthritis. Methods This Delphi study consisted of interviews, an online questionnaire, and focus groups. Participants were physical therapists, patients with hip and/or knee osteoarthritis with or without experience in digital care, and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the Consolidated Framework For Implementation Research. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators, and barriers were discussed. In the second phase, an online questionnaire and focus groups served the process to confirm the needs and collect preconditions. The online questionnaire contained statements drawn by the results of the interviews. Patients and physical therapists were invited to complete the questionnaire and participate in one of the three focus groups including (1) patients; (2) physical therapists; and (3) a patient, a physical therapist, and stakeholders from the health care system. The focus groups were used to determine concordance with the results of the interviews and the online questionnaire. Results Nine physical therapists, seven patients, and six stakeholders confirmed that an increase of acceptance of the digital care part by physical therapists and patients is crucial. One of the most frequently mentioned facilitators was conducting regular in-person sessions. Physical therapists and patients concluded that blended physical therapy must be tailored to the patients’ needs. Participants of the last focus group stated that the reimbursement of blended physical therapy needs to be clarified. Conclusions Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists toward digital care. Overall, for development and usage purposes, it is crucial to take the needs and preconditions into account. Trial Registration German Clinical Trials Register DRKS00023386; https://drks.de/search/en/trial/DRKS00023386

BACKGROUND Osteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially combined with in-person sessions seems to be promising. OBJECTIVE The aim of this study was to investigate the needs, preconditions, barriers and facilitators of blended physical therapy. METHODS This Delphi study consisted of interviews, an online survey and focus groups. Participants were physical therapists, patients with hip or knee osteoarthritis with or without experience in digital care and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the Consolidated Framework For Implementation Research. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators and barriers were discussed. In the second phase, an online survey and focus groups served the process to confirm the needs and collect preconditions. RESULTS Nine physical therapists, seven patients and six stakeholders confirm that an increase of acceptance of digital care by physical therapists and patients is crucial. One of the most frequently mentioned facilitator was conducting regular in-person sessions. Physical therapists and patients conclude that blended physical therapy needs to be tailored to the patients needs. The reimbursement of blended physical therapy needs to be clarified. Discussion: Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists towards digital care. Overall, for development and implementation purposes, it is crucial to take the needs and preconditions into account. CONCLUSIONS Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists towards digital care. Overall, for development and implementation purposes, it is crucial to take the needs and preconditions into account. CLINICALTRIAL DRKS00023386

BACKGROUND 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. OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.