Posts Tagged smartphone

[ARTICLE] A smartphone application to facilitate adherence to home-based exercise after flexor tendon repair: A randomised controlled trial – Full Text



Evaluate the effect of a smartphone application on exercise adherence, range of motion and self-efficacy compared to standard rehabilitation after repair of the flexor digitorum profundus tendon.


Prospective multi-centre randomised controlled trial.


Four hand surgery departments in Sweden.


A total of 101 patients (35 women) (mean age 37.5 ± 12.8) were randomised to control (n = 49) or intervention group (n = 52).


A smartphone application to facilitate rehabilitation.

Main outcome measures:

Adherence assessed with the Sport Injury Rehabilitation Adherence Scale at two and six weeks (primary outcome). Secondary outcomes were self-reported adherence in three domains assessed at two and six weeks, self-efficacy assessed with Athlete Injury Self-Efficacy Questionnaire at baseline, two and six weeks. Range of motion and perceived satisfaction with rehabilitation and information were assessed at 12 weeks.


Twenty-five patients were lost to follow-up. There was no significant between group difference in Sport Injury Rehabilitation Adherence Scale at two or six weeks, mean scores (confidence interval, CI 95%) 12.5 (CI 11.8–13.3), 11.8 (CI 11.0–12.8) for the intervention group, and 13.3 (CI 12.6–14.0), 12.8 (CI 12.0–13.7) for the control group. Self-reported adherence for exercise frequency at six weeks was significantly better for the intervention group, 93.2 (CI 86.9–99.5) compared to the controls 82.9 (CI 76.9–88.8) (P = 0.02). There were no differences in range of motion, self-efficacy or satisfaction.


The smartphone application used in this study did not improve adherence, self-efficacy or range of motion compared to standard rehabilitation for flexor tendon injuries. Further research regarding smartphone applications is needed.

Tendon rupture and adhesions are common problems during the rehabilitation of patients with flexor tendon injuries in the hand and reoperation rates of up to 13% have been reported.1 Home exercise programmes are considered important for reaching a successful outcome after flexor tendon repair.2,3 In these exercise programmes there is a delicate balance between getting enough tendon motion to minimise adhesions and having a load that is low enough to prevent tendon rupture. These programmes consist of regular home-based exercises, often recommended by a physiotherapist or an occupational therapist to do on an hourly basis in order to prevent joint stiffness and adhesions. This creates high demands on patients and their adherence to the rehabilitation protocol. Poor adherence to restrictions has been linked to an increased risk of tendon rupture after flexor tendon repair.4,5

Patients belief in their own ability (self-efficacy) to perform the necessary exercises has been shown to predict adherence to home-based physical therapy in general.6 However, the lack of studies on adherence to home based exercise after flexor tendon repair makes the evidence on how to improve adherence insufficient and the impact on clinical outcome unclear in this patient group.7,8

It has been shown that a smartphone application can be an effective tool for increasing adherence to home-based exercise.9,10 However, evidence that the intervention improves exercise adherence after traumatic conditions in the upper limbs is still insufficient.8 The main aim of this study was to explore a new and specifically designed smartphone application for flexor tendon rehabilitation and the effect on adherence to home-based exercise, self-efficacy and finger range of motion. We hypothesised that, compared to the control group, the intervention group that received the smartphone application would show a significantly higher adherence to exercise and self-efficacy after two and six weeks of rehabilitation and a higher total active finger range of motion at 12 weeks after surgery.[…]

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[Guide] Easy to access assistive technology and apps for individual success – PDF file

Abstract: The COVID-19 pandemic presents an opportunity to spend time with individuals exploring and learning to use different assistive technology (AT) and apps that can be used now and in the future. For individuals who are working during the pandemic, at a time when in-person supports from a job coach may be limited or not available, AT and apps can increase their ability to self-manage on the job. This brief focuses on the various AT options that can be accessed through smartphones and tablets, often for free, to support employment, personal, and independent-living goals. Much of the technology discussed in this publication can also be accessed via desktop and laptop computers.

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[ARTICLE] In-Home Rehabilitation Using a Smartphone App Coupled With 3D Printed Functional Objects: Single-Subject Design Study – Full Text


Background: Stroke is a major cause of long-term disability. While there is potential for improvements long after stroke onset, there is little to support functional recovery across the lifespan. mHealth solutions can help fill this gap. mRehab was designed to guide individuals with stroke through a home program and provide performance feedback.

Objective: To examine if individuals with chronic stroke can use mRehab at home to improve upper limb mobility. The secondary objective was to examine if changes in limb mobility transferred to standardized clinical assessments.

Methods: mRehab consists of a smartphone coupled with 3D printed household items: mug, bowl, key, and doorknob. The smartphone custom app guides task-oriented activities and measures both time to complete an activity and quality of movement (smoothness/accuracy). It also provides performance-based feedback to aid the user in self-monitoring their performance. Task-oriented activities were categorized as (1) object transportation, (2) prehensile grip with supination/pronation, (3) fractionated finger movement, and (4) walking with object. A total of 18 individuals with stroke enrolled in the single-subject experimental design study consisting of pretesting, a 6-week mRehab home program, and posttesting. Pre- and posttesting included both in-laboratory clinical assessments and in-home mRehab recorded samples of task performance. During the home program, mRehab recorded performance data. A System Usability Scale assessed user’s perception of mRehab.

Results: A total of 16 participants completed the study and their data are presented in the results. The average days of exercise for each mRehab activity ranged from 15.93 to 21.19 days. This level of adherence was sufficient for improvements in time (t15=2.555, P=.02) and smoothness (t15=3.483, P=.003) in object transportation. Clinical assessments indicated improvements in functional performance (t15=2.675, P=.02) and hand dexterity (t15=2.629, P=.02). Participant’s perception of mRehab was positive.

Conclusions: Despite heterogeneity in participants’ use of mRehab, there were improvements in upper limb mobility. Smartphone-based portable technology can support home rehabilitation programs in chronic conditions such as stroke. The ability to record performance data from home rehabilitation offers new insights into the impact of home programs on outcomes.



Stroke is a major cause of disability, leading to restriction of occupational performance for stroke survivors [1,2]. It is estimated that 30%-60% of stroke survivors continue to have residual limitations in upper extremity movements after traditional rehabilitation services [3]. At the end of rehabilitation services, survivors are commonly given a written home exercise program to guide recovery in chronic stages of stroke [4]. Shortcomings of the written home exercise program include complaints of being unengaging and patients not continuing the program [4]. Knowing that upper limb motor deficits can reduce quality of life [5], it is important to support survivors to recover as much function as possible. Upper limb recovery after stroke is identified as a research priority by survivors of stroke, caregivers, and health professionals [6].

Research demonstrates that individuals with chronic stroke are capable of making gains in performance with continued practice. The research so far has focused on interventions led by therapists [7,8]. It is improbable that direct oversight by a therapist is a feasible solution for long-term recovery. For chronic conditions such as stroke, better supporting the individual’s ability to self-manage their long-term recovery could offer a more sustainable approach. Use of mHealth (ie, mobile technology to manage health) offers the opportunity for individuals to engage in rehabilitative activities while monitoring their performance and managing their health behaviors [9,10]. mHealth apps can assist users in meeting basic needs, thereby giving a sense of autonomy and competence [11]. In addition, participants have reported that it is enjoyable to use apps [12]. Smart devices are equipped with interactive components (eg, sensors, cameras, speakers, and vibrators) capable of measuring human movement and providing feedback [13]. Readily available smartphone technology can be the basis of a home rehabilitation system.

There has been an increase in app development for stroke rehabilitation. A review of apps designed for stroke survivors or their caregivers found that 62% of apps addressed language or communication [14]. Other apps addressed stroke risk calculation, identifying acute stroke, atrial fibrillation, direction to emergency room or nearest certified stroke center, visual attention therapy, and a mere 4% addressed physical rehabilitation [14]. Importantly, apps for rehabilitation did not focus on upper limb function [14]. Use of technology to guide and measure performance in task-specific training of the upper extremity after stroke has primarily included clinical or laboratory-based interventions [15,16]. Task-specific programs are function based, with practice of tasks relevant to activities of daily life, and have been shown to be efficacious [17,18]. Use of instrumented objects in a laboratory setting has resulted in patients reporting they enjoyed the experience [15]. There has been less research on the use of portable technology for upper limb rehabilitation in a home setting for individuals with chronic arm/hand deficits after stroke.

Previous Work

mRehab (mobile Rehab) was created to better support in-home upper limb rehabilitation programs (Figure 1) [13]. It incorporates a task-oriented approach and immediate performance-based feedback. Exercise programs that include feedback have resulted in better outcomes compared with programs without feedback [19,20]. mRehab consists of 3D printed household objects (a mug, bowl, key, and doorknob) integrated with a smartphone and an app. The app guides participants through practice of activities of daily living, for example, sipping from a mug. It can also consistently measure time to complete an activity and quality of movement (smoothness/accuracy) during the performance of activities of daily living. The system is described in more detail in previous articles that have evaluated it in primarily laboratory-based settings [13,21].

Figure 1. In-home use of mRehab: (A) selecting an activity in mRehab; (B) turning key activity; and (C) vertical mug transfer activity.

There is little information on in-home use of technology for rehabilitation in chronic stroke. While technology-based systems designed for rehabilitation have been developed, they have typically been examined in laboratory or clinical settings [22,23]. The results of this study will provide much needed evidence of the ability of individuals with chronic stroke to use technology in a home-based program with oversight only upon request. This mimics clinical practice, in which patients are discharged from rehabilitation with a home program and then need to self-manage their recovery. We examine the individual’s adherence to exercise and if they required support with the technology. The impact of the home-based mRehab program on functional mobility was also examined. While individuals with chronic stroke were selected for the first examination of mRehab in a home-based setting, the system has the potential to be used by individuals that have arm/hand deficits due to other underlying pathology.[…]

Continue —-> JMU – In-Home Rehabilitation Using a Smartphone App Coupled With 3D Printed Functional Objects: Single-Subject Design Study | Langan | JMIR mHealth and uHealth

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[Abstract] Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial – description of device use and physiotherapy support in the post-hospital phase


To describe device use and physiotherapy support in the post-hospital phase of the AMOUNT rehabilitation trial.


We performed an evaluation of the support required for device use by participants randomised to the intervention group who received digitally-enabled rehabilitation in the post-hospital phase (n = 144). Intervention, additional to standard rehabilitation, utilised eight digital devices (virtual reality videogames, activity monitors and handheld computer devices) to improve mobility and increase physical activity. Participants were taught to use devices during inpatient rehabilitation and were then discharged home to use the devices for the remainder of the 6-month trial. Physiotherapist-participant contact occurred every 1–2 weeks using a health coaching approach, including technology support when required. Intervention datasheets were audited, and descriptive statistics used to report device use and support required.


Participants (mean (SD) age 70 (18) years; 49% neurological health conditions) used an average of 2 (SD 1) devices (98% used an activity monitor). Eight percent of physiotherapy contact included technology support with 30% provided remotely. Support addressed 845 issues categorised under initial set-up and instruction (27%), education and training (31%), maintenance (23%) and trouble-shooting (19%).


Digital devices can be used for home-based rehabilitation, but ongoing technology support is essential.


  • Digital device use at home to support long-term management of health conditions is likely to become increasingly important as the need for rehabilitation increases and rehabilitation resources become more limited.

  • Technology support for set-up and ongoing device use is a critical enabler of home-based digital interventions.

  • Health professionals delivering home-based digital interventions require sufficient training and equipment and may need to vary the mode (e.g., home visit vs. telephone or video conference) depending on the technology support required.

via Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial – description of device use and physiotherapy support in the post-hospital phase: Disability and Rehabilitation: Vol 0, No 0

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[WEB PAGE] Wearable-tech glove translates sign language into speech in real time: The device is inexpensive, flexible and highly durable

Date: June 29, 2020

Summary: Bioengineers have designed a glove-like device that can translate American Sign Language into English speech in real time though a smartphone app. The system includes a pair of gloves with thin, stretchable sensors that run the length of each of the five fingers. These sensors, made from electrically conducting yarns, pick up hand motions and finger placements that stand for individual letters, numbers, words and phrases.


UCLA bioengineers have designed a glove-like device that can translate American Sign Language into English speech in real time though a smartphone app. Their research is published in the journal Nature Electronics.

“Our hope is that this opens up an easy way for people who use sign language to communicate directly with non-signers without needing someone else to translate for them,” said Jun Chen, an assistant professor of bioengineering at the UCLA Samueli School of Engineering and the principal investigator on the research. “In addition, we hope it can help more people learn sign language themselves.”

The system includes a pair of gloves with thin, stretchable sensors that run the length of each of the five fingers. These sensors, made from electrically conducting yarns, pick up hand motions and finger placements that stand for individual letters, numbers, words and phrases.

The device then turns the finger movements into electrical signals, which are sent to a dollar-coin-sized circuit board worn on the wrist. The board transmits those signals wirelessly to a smartphone that translates them into spoken words at the rate of about a one word per second.

The researchers also added adhesive sensors to testers’ faces — in between their eyebrows and on one side of their mouths — to capture facial expressions that are a part of American Sign Language.

Previous wearable systems that offered translation from American Sign Language were limited by bulky and heavy device designs or were uncomfortable to wear, Chen said.

The device developed by the UCLA team is made from lightweight and inexpensive but long-lasting, stretchable polymers. The electronic sensors are also very flexible and inexpensive.

In testing the device, the researchers worked with four people who are deaf and use American Sign Language. The wearers repeated each hand gesture 15 times. A custom machine-learning algorithm turned these gestures into the letters, numbers and words they represented. The system recognized 660 signs, including each letter of the alphabet and numbers 0 through 9.

via Wearable-tech glove translates sign language into speech in real time: The device is inexpensive, flexible and highly durable — ScienceDaily

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[WEB PAGE] All in the Wrist: Wearables Help Treat Disease, Disability

Suffering a stroke can change how your body works in odd ways. Maybe you suddenly can’t lift your leg the way you did a few weeks before, or your arm doesn’t seem to extend properly. It’s different for every case.

Recovering from these disabilities can be an arduous process. A patient must not only struggle with his or her impairments, but also the conviction to overcome them. At the hospital, therapists coach rehabbing patients through intense exercise schedules, but after being sent home, patients won’t be monitored as closely and often stop using disabled limbs, favoring healthier body parts instead. This often results in more lost functionality.

Doctors have long been perplexed about how to effectively help patients who aren’t in the exam room or rehab clinic. Researchers and programmers are now developing a new generation of wearables that can monitor, encourage, and even treat people suffering from chronic neurological disorders like stroke, cerebral palsy, and epilepsy, as well as the essential tremors that come with Parkinson’s Disease.

Practice makes perfect

Around 2015, Belén Rubio Ballester, a researcher at Spain’s IBEC Institute for Bioengineering of Catalonia (IBEC), fixated on a specific challenge faced by patients recovering from stroke: Use it or lose it.

“You practice, you learn — if you quit practicing, you lose your skills,” says Ballester. “We see this everywhere, whether you’re playing an instrument or in sports. Stroke patients may similarly lose some motor function.”

It’s common for rehab patients to favor their stronger muscles, usually to the detriment of debilitated fingers, hands, and legs. To remedy this, Ballester launched a pilot experiment to see if a watch-like wearable connected to a smartphone could influence patient behavior. Subjects were fitted with a bracelet-like prototype that buzzed once an hour to remind stroke sufferers to use their arms, and an app installed on a paired phone checked for movement that confirmed the patient actually followed the advice. It was a small study, monitoring just four trainees over five days, but the results were consistent: The techno nudge helped.

rehab session
BSIP / Getty

In March, the same team launched a follow-up study that promises to be one of the largest experiments of its kind, training and tracking 100 recovering stroke patients with a combination of smartphones and Android Wear watches.

Similar to the original homegrown bracelets, the Android watches will buzz once an hour to remind patients not to forget they need to exercise their impaired limbs. Study participants will also be able to see their usage quantified on paired smartphones. The Android Wear gyroscope makes it easier for the researchers to track the type of movements. Each patient will be asked to regularly draw circles to check the fluidity of the gesture.

Employing Android Wear is more of a practical choice than tech preference. Android watches tend to be cheaper than Apple ones or other comparable gear, and since the researchers aren’t providing phones, they’re banking on patients owning compatible gear.

Ballester projects initial data for the study will be available by December 2020. The IBEC team also plans to track the patients after they’ve stopped wearing the watches to check if the habits developed by the recurring buzzes will stick. The full results should be completed by the middle of 2021.

Wearables to monitor neurological disorders

On the other side of the Atlantic, Rutgers University professor Jean-Francois Daneault is using wearables, phones, and robotics to monitor and treat patients with a range of neurological disorders, including stroke, cerebral palsy and essential tremor. In 2019, he won a $400,000 grant from the National Institutes of Health to develop a platform that will track patients over long periods to help diagnose those impairments.

“A lot of those ailments have overlapping symptoms,” said Daneault. “Doctors who aren’t specialists can have a hard time identifying the differences between the diseases.” A well-attuned wearable, in combination with a smartphone app, can capture those often imperceptible symptoms that give a doctor the necessary stats to make an informed diagnosis.

The platform will also potentially be used to measure how symptoms may change over months and years. “People may only see their neurologists or doctors once or twice a year, for a limited amount of time, so it can be difficult to know how they’re doing,” says Daneault. A well-done app can tell a doctor if a medication is working or if the treatment needs to be adjusted.


“There are very few specialists, and they’re always booked,” he says, underscoring the need for more monitoring of patient ailments.

Though Denault is attempting to build a platform that can work with Android Wear, Apple watches, and Fitbits, the wrist-worn tech can measure more than just arm and hand actions. Gait can also be tracked with a wearable or a smartphone placed in a pocket.

One of the big challenges of making a platform that works with multiple wearables is understanding the slight differences between the gyroscopes and accelerometers embedded into each. Daneault realizes the practical challenges such a platform must overcome: The app will need to pick through a wealth of data and parse out the most relevant information, and also find ways to integrate what is learned into numerous digital health systems.

Researchers are developing parallel tech and functionality at numerous schools, hospitals, and institutions. Doctors at the Cleveland Clinic are using iPads to measure the balance of multiple sclerosis (MS) patients. An A.I. expert at the Massachusetts Institute of Technology developed a smartwatch that can look for the signs of epilepsy seizures and predict their onset before they occur. There’s even a Google X project that uses Fitbits to help track the progression of MS symptoms.

Not all of these projects are ready for prime time, but the U.S. Food and Drug Administration (FDA) has already approved a few wearables that can monitor and treat neurological issues, and they are now commercially available. The Embrace wearable, for example, is a bracelet that monitors wearers for stress and potential seizures. A device called Trio, on the other hand, delivers peripheral nerve stimulation to ameliorate the symptoms of essential tremor. A clinical study of the device showed that using it decreases the amount of hand shaking, often caused by Parkinson’s disease, within three months.

Such products are just the early signs of how the treatment of neurological disorders is about to radically change.

“The future of motor rehab is not at the hospital,” says IBEC researcher Ballester. “You want patients to go home as soon as they feel safe and want to, and things are prepared at home. But you don’t want to lose track of them. You want rehab embedded in life. If it isn’t, it won’t be maintained … That’s why I see rehab in the life of the patient. Not at the hospital.”

Editors’ Recommendations

via All in the Wrist: Wearables Help Treat Disease, Disability | Digital Trends

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[Abstract] Use of mobile applications in hand therapy



Mobile devices can be incorporated into therapy as an engaging alternative to traditional therapy options. The use of mobile devices and smartphone applications can enhance the quality of care provided by health care professionals.


To find mobile apps that can be incorporated into hand therapy practice.


Hand therapy evaluation, interventions, proprioception, laterality, and home exercise program applications can be incorporated into practice. Patient education can also be provided via the use of mobile applications.


Smartphone applications can be a valuable intervention and impact performance in individuals with impaired hand function. Smartphone applications offer a client-centered, and potentially motivating, activity option that can be utilized to aid the hand therapist.

via Use of mobile applications in hand therapy – ScienceDirect

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[BLOG POST] The Dirty Dozen – 12 Ways To Cope With Memory Loss – HOPE TBI

  1. Make a memory board (with important names and frequently used phone whiteboard2numbers).  Hang somewhere visible, so it can be seen and utilized daily.  Update the same day weekly or as schedules change.
  2. Create a life story book, photo album or something digital that is labeled to help identify who and what is important to remember (people, places, experiences).  Get assistance to from someone you trust (such as a family member or professional) to do this. This can include pictures, question and answer format, or whatever works for your particular needs. This serves as a dual purpose as well, as it can also be used by professionals or caregivers to understand more about you as well.
  3. Cognitive stimulation. This involves activities and exercises that stimulate thinking, concentration, communication and memory. braingamesgenderUtilizing brain exercise sites such as  Lumosity , Constant Therapy, and CogniFit Brain Training; play strategy games (like cards, checkers, chess, crossword puzzles, word finds, puzzles); coloring, drawing, or listening to different types of music.
  4. Utilize a reminder system (this may include calendar, white boards, chart on the wall).  It could be color coded as well (so a different color for each person or different color for each appointment on schedule – just make sure you use same color each time you do the schedule). Using A Planner or a Calendar App? –  write down things right away – without exception. Always keep the planner with you wherever you go.  If you get a call about an appointment, write it down IN THE PLANNER.planner  If something changes in the schedule, write it down IN THE PLANNER.  Label cupboards and storage containers as a reminder of where things are kept; label doors as a reminder of which room is which.
  5. LISTS are your friends and great reminders (note: if you have trouble writing, use a voice recorder or dictaphone to make lists).  Consider making permanent signs – even having them laminated, to remind you of things you need to do regularly (for example – sign by the sink reminding you to wash your hands before cooking or before leaving the bathroom).  Make a list for things you are running out of and leave attached to the refrigerator door (this is a great way to make a grocery list you take to the store with you).  Make a list of what bills are due on what days and how much each bill is that is due, along with how it is paid.  Make a list of daily tasks that need accomplished.  Make (or have someone make) a checklist to hang by the front door that includes what you need when you leave (for example: purse/wallet, phone, phone charger, planner, meds, bottle of water, keys, sunglasses, ear plugs, jacket, etc).  Use the checklist EVERY TIME before you walk out the door.  This reduces chances of forgetting things.
  6. stickynotesUse post-it/sticky notes. You can use them anywhere in your home or personal workspace to remind you to do specific tasks (such as a sticky on a library book that has to be returned by a certain date, or start load of laundry today, etc).Once you have completed the task, it’s important to throw the post-it/sticky note away. This way you won’t accidentally redo what you already finished.
  7. Use a mobile smartphone (cell phone). Many mobile phones have a built-in voice recorder. Use this  to record information that you need to remember or add items to your virtual calendar. You could also leave recorded notes, play it back later, or review those notes at the same time each day.  Also cell phones are great resources for text reminders, checking emails, and having access to a GPS (such as Google maps) to utilize to keep from getting lost. Use your phone to take picture of your whiteboard schedule that week so when you leave home you can look at the picture even if you aren’t at home to see it.  Use an app to record incoming/outgoing phone calls (check your State or Country laws first though, about recording these in your particular location).
  8. Medicine/Pill reminder box.  This will help you see whether you have taken your medications for that day (this helps to prevent taking your medications more than once). Some models have am/pm, and other times of the day; pillboxsome can be set to remind you when to take your pills, with an alarm, vibration or flashing light.
  9. Use an alarm clock, a watch with an alarm, or a kitchen timer to remind you when you need to leave the house for an ­appointment, or when you have to check something cooking in the oven. Write down why you have set the alarm – so you know why it is ­going off. (I cannot tell you the number of times I have had an alarm going off and then sat there wondering why I set it. So notes are very helpful – put by the alarm)
  10. Never leave the room when you are cooking.  You may forget what you were doing and this increases risk of burning your food, burning up a pan, or causing a fire.  Never leave the room when water is running in a sink or bathtub. You may forget about it and cause a flood.
  11. Appointments and Meetings. In advance, make a detailed list of what you want to say, questions you have, agenda for meeting, etc.  If you are going to a medical appointment, bring a pre-typed list to leave with the provider of all other providers/specialists (make sure this includes their addresses, phone numbers or contact informatioLeadership with educationn), all medications and their dosages (remember to list any herbs, supplements taking), and list of concerns. Record meetings or appointments to go back and listen to later and take notes from the recording.
  12. Don’t procrastinate. Whenever possible, doing things when they’re on your mind rather than later so you don’t have to worry about forgetting them. Try to utilize the same routine every day as much as possible.  Routine reduces chances of forgetting.

via The Dirty Dozen – 12 Ways To Cope With Memory Loss | HOPE TBI

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[Abstract + References] Mobile, Exercise-agnostic, Sensor-based Serious Games for Physical Rehabilitation at Home


Serious games can improve the physical rehabilitation of patients with different conditions. By monitoring exercises and offering feedback, serious games promote the correct execution of exercises outside the clinic. Nevertheless, existing serious games are limited to specific exercises, which reduces their practical impact. This paper describes the design of three exercise-agnostic games, that can be used for a multitude of rehabilitation scenarios. The developed games are displayed on a smartphone and are controlled by a wearable device, containing inertial and electromyography sensors. Results from a preliminary evaluation with 10 users are discussed, together with plans for future work.


  1. Steven Dow, Blair MacIntyre, Jaemin Lee, Christopher Oezbek, Jay David Bolter, and Maribeth Gandy. 2005. Wizard of Oz Support Throughout an Iterative Design Process. IEEE Pervasive Computing 4, 4 (Oct. 2005), 18–26. Google ScholarDigital Library
  2. Brook Galna, Dan Jackson, Guy Schofield, Roisin McNaney, Mary Webster, Gillian Barry, Dadirayi Mhiripiri, Madeline Balaam, Patrick Olivier, and Lynn Rochester. 2014. Retraining function in people with Parkinson’s disease using the Microsoft kinect: game design and pilot testing. Journal of NeuroEngineering and Rehabilitation 11, 1 (14 Apr 2014), 60.Google ScholarCross Ref
  3. S.J. Ge_en. 2003. Rehabilitation principles for treating chronic musculoskeletal injuries. Med J Aust 178, 5 (2003), 238–242.Google ScholarCross Ref
  4. Maureen Kerwin, Francisco Nunes, and Paula Alexandra Silva. 2012. Dance! Don’t Fall – preventing falls and promoting exercise at home. Studies in health technology and informatics 177 (2012), 254259. Scholar
  5. K. Laver, S. George, J. Ratcli_e, S. Quinn, C. Whitehead, O. Davies, and M. Crotty. 2011. Use of an interactive video gaming program compared with conventional physiotherapy for hospitalised older adults: a feasibility trial. Disability and Rehabilitation 34, 21 (2011), 1802–1808.Google ScholarCross Ref
  6. Gwyn N. Lewis, Claire Woods, Juliet A. Rosie, and Kathryn M. Mcpherson. 2011. Virtual reality games for rehabilitation of people with stroke: perspectives from the users. Disability and Rehabilitation: Assistive Technology 6, 5 (2011), 453–463.Google ScholarCross Ref
  7. Simon McCallum. 2012. Gami_cation and serious games for personalized health. Stud Health Technol Inform 177 (2012), 85–96.Google Scholar
  8. Brian A. Primack, Mary V. Carroll, Megan McNamara, Mary Lou Klem, Brandy King, Michael Rich, Chun W. Chan, and Smita Nayak. 2012. Role of Video Games in Improving Health-Related Outcomes: A Systematic Review. American Journal of Preventive Medicine 42, 6 (2012), 630–638.Google ScholarCross Ref
  9. A. Santos, V. Guimares, N. Matos, J. Cevada, C. Ferreira, and I. Sousa. 2015. Multi-sensor exercise-based interactive games for fall prevention and rehabilitation. In 9th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth). 65–71. Google ScholarDigital Library
  10. Devinder Kaur Ajit Singh, Nor Azlin Mohd Nordin, Noor Azah Abd Aziz, Beng Kooi Lim, and Li Ching Soh. 2013. E_ects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. BMC Neurology 13, 1 (13 Dec 2013), 199.Google Scholar
  11. Jan David Smeddinck, Marc Herrlich, and Rainer Malaka. 2015. Exergames for Physiotherapy and Rehabilitation: A Medium-term Situated Study of Motivational Aspects and Impact on Functional Reach. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (CHI ’15). ACM, New York, NY, USA, 4143–4146. Google ScholarDigital Library
  12. Gabriele Spina, Guannan Huang, Anouk Vaes, Martijn Spruit, and Oliver Amft. 2013. COPDTrainer: A Smartphone-based Motion Rehabilitation Training System with Real-time Acoustic Feedback. In Proceedings of the 2013 ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp ’13). ACM, New York, NY, USA, 597–606. Google ScholarDigital Library

via Mobile, Exercise-agnostic, Sensor-based Serious Games for Physical Rehabilitation at Home | Proceedings of the Twelfth International Conference on Tangible, Embedded, and Embodied Interaction

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[BLOG POST] 5 Smartphone Games That Encourage Wrist Rehabilitation

Tired of using dumbbells for rehabilitation following distal radius fractures? Looking for new interventions to increase client engagement? Look no further than your patient’s smartphone! Incorporate it into exercise routines to help your patients regain wrist balance and to provide proprioceptive input.

Evidence Supports Proprioceptive Activities

Emerging evidence supports the use of proprioceptive activities for distal radius fracture rehabilitation.1 A cross-sectional study involving females treated operatively and non-operatively for a distal radius fracture found that participants had significantly less joint position sense in comparison to study controls.2 The proprioceptive limitations correlated highly with functional impairment on the Patient Rated Wrist Evaluation.3

By addressing proprioceptive deficits while encouraging functional wrist range of motion, smartphone applications complement a traditional hand therapy program for individuals requiring skilled therapy following a distal radius fracture.

Some games to consider:

  • Chopper Lite – Action packed side-scrolling helicopter game where a tilt of the screen flies the chopper.
  • Labyrinth – Classic labyrinth game in which you must guide a ball through a labyrinth by moving your device.
  • Tilt Maze Lite – Maze game where a tilt of your device helps a marble through a maze toward the exit. Use different mazes to test wrist balance and timing. The game stores the player’s best time for each maze so patients can track their performance as their wrist heals.
  • Water Slide Extreme – Unique water slide game featuring tight corners and huge loops that you must navigate by twisting or leaning your device.
  • Snail Mail – Kart-style racing game in which the player controls a racing snail on a mission to collect packages and deliver them to the farthest reaches of the universe while dodging obstacles such as laser towers, slugs, asteroids, and salt.

The clinician should consider using smartphones as an intervention following distal radius fractures. Skilled hand therapists can assist with appropriate postural mechanics and provide guidelines for the amount of time a patient should devote to gaming.

Rehabilitation at Your Fingertips

Certain smartphone applications can be used to address client-specific deficits, decrease functional concerns, and achieve client-centered goals. Incorporating smartphone gaming in hand therapy may provide motivation and convenience to your clients.



  1. Algar, L., & Valdes, K. (2014). Using smartphone applications as hand therapy interventions. Journal of Hand Therapy27(3), 254–257. doi:10.1016/j.jht.2013.12.009
  2. Karagiannopoulos, C., Sitler, M., Michlovitz, S., & Tierney, R. (2014a). A Descriptive Study on Wrist and Hand Sensori-Motor Impairment and Function Following Distal Radius Fracture Intervention. Journal of Hand Therapy27(3), e2–e3. doi:10.1016/j.jht.2013.08.006
  3. Karangiannopoulos, et al. (2014)

via 5 Smartphone Games That Encourage Wrist Rehabilitation | MedBridge Blog

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