预防和康复领域的技术-社论

IF 1.5 Q3 REHABILITATION European Journal of Physiotherapy Pub Date : 2022-10-10 DOI:10.1080/21679169.2022.2131152
E. Ekvall Hansson
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引用次数: 0

摘要

新技术为预防和康复领域的研究和临床实践开辟了新的可能性。例如,加速度计、陀螺仪和鞋垫力诱导器等可穿戴传感器用于跌倒风险评估[1]、跌倒检测[2,3]和康复计划[4]。此外,有一些证据表明,虚拟现实和视频游戏可能是上肢中风康复的有用辅助手段,但没有足够的证据表明它们对平衡和功能[5]或手的灵活性和步态[6]的影响。然而,经济实惠且可行的技术,例如来自视频游戏行业的技术和用于视频记录图像分析的改进算法,允许对运动行为进行有效可靠的客观测量[7]。这些技术为临床评估以及基于反馈的训练协议开辟了新的可能性,包括本体感觉评估的特定方法[8]。智能手机和智能手表等移动健康技术也为个性化干预提供了新的方法,可以对自己的行为进行反馈,并有可能增加干预的接受率,并随着时间的推移改变行为[9]。在我们作为物理治疗师压力越来越大的工作生活中,采用可能具有上述所有优点的新技术当然很诱人。然而,为了为临床实践提供证据,所有这些新技术都需要以与物理治疗实践和科学中使用的所有测量功能的疗法和方法相同的科学方式进行仔细审查。因此,需要像在理疗实践中检索信息的其他方法一样,对技术的有效性和可靠性进行测试。此外,包括现代技术在内的不同干预措施的效果也必须以科学的方式进行测试。因此,迫切需要进行研究,包括测试新技术的有效性和可靠性,以及测量包括技术在内的干预措施效果的随机对照试验。有效性领域正在进行的研究的一个例子是瑞典马尔默的一个髋关节康复项目,在该项目中,可穿戴移动跟踪器被用作康复的附加设备[4]。随机对照试验中的干预措施包括使用名为Stumbelometer(www.infoomy.com)的惯性测量单元(IMU)进行结构化康复,作为结构化康复的附加组件。IMU收集每天坐、站、躺和走步的时间、步行速度和步长的数据。理疗师获得有关功能进展的具体知识,既可以向患者提供反馈,也可以在康复过程中使用这些信息进行个性化锻炼。作为一名研究人员和执业理疗师,我敦促我的所有同事在临床实践中采用技术时,利用你在科学方法和最佳可用证据方面的知识和技能。这样,我们就可以在康复和研究中接受和使用有效、有效和可靠的新技术。
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Technology in the field of prevention and rehabilitation - Editorial
New technology opens new possibilities in the field of prevention and rehabilitation, both in research and in clinical practice. For example, wearable sensors such as accelerometers, gyroscopes and insole force inducers, are used for fall risk assessment [1], for fall detection [2,3] and in rehabilitation programs [4]. Furthermore, there is some evidence that virtual reality and video gaming may be a useful adjunct to stroke rehabilitation for the upper limb but there is insufficient evidence about the effect of those on balance and function [5] or for hand dexterity and gait [6]. However, affordable and feasible technology, e.g. from the video gaming industry and improved algorithms for image analyses of video recordings, allow for valid and reliable objective measurements of movement behaviour [7]. These technologies open new possibilities for clinical assessments as well as feedback based training protocols, including specific methods for assessment of proprioception [8]. Mobile health technology like smart phones and smart watches also offers new approaches for personalised interventions with feedback on own behaviour and has the potential to increase uptake of interventions and change behaviour over time [9]. In our more and more stressful working life as practicing physiotherapist, it is of course tempting to adopt new technology that might have all the advantages mentioned above. However, to evidence-base clinical practice, all these new technologies need to be scrutinised in the same scientific way as all therapies and methods for measuring function, used in physiotherapy practice and as is done in science. Hence, technology need to be tested for validity and reliability in the same way as other methods for retrieving information in physiotherapy practice. Additionally, the effect of different interventions, including modern technology, must also be tested in a scientific way. Therefore, research including test for validity and reliability of new technology, as well as randomised controlled trials to measure the effect of interventions including technology, is highly demanded. One example of ongoing research in the effectiveness area, is a hip-rehabilitation project in Malm€ o, Sweden, where wearable mobility trackers are used as add-on in rehabilitation [4]. The intervention in the randomised controlled trial comprises of structured rehabilitation with an Inertial Measurement Unit (IMU) called the Stumbelometer (www.infonomy.com) as an add-on the structured rehabilitation. The IMU collects data on time spent in sitting, standing, lying down and on steps per day, walking speed and step length. The physiotherapist gets specific knowledge about progression on function and can both give feedback to the patient and use the information for individualising exercises during rehabilitation. As a researcher and a practicing physiotherapist, I urge all my colleagues to use your knowledge and skills of scientific methods and best available evidence when adopting technology in clinical practice. In that way, we can embrace and use new technology in rehabilitation and in research, that is effective, valid, and reliable.
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29
期刊最新文献
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