Upper-extremity injuries and diseases rarely have life-threatening consequences, but failure to manage them properly can result in severe dysfunction. This article presents the current state of using virtual reality to support the rehabilitation process of patients with injuries and diseases of the upper extremities and points out their effects on upper-extremity functions. A scoping review was conducted to provide a comprehensive overview of the field of virtual reality for upper-extremity rehabilitation. PubMed, Web of Science, and the Cochrane Library were searched by two independent researchers between April and May 2021 to identify relevant publications and were examined according to inclusion and exclusion criteria. As a result of the literature review, 11 studies of various target groups were identified. Virtual-reality technologies were categorized into multisensory high-end systems and game-based systems. With respect to functional recovery, technologies based on virtual reality were not inferior to traditional rehabilitation. In addition, the users were highly motivated and satisfied. The results emphasize the need for stronger evidence-based virtual-reality technologies for rehabilitation of injuries and diseases of upper extremities.

Due to the coronavirus pandemic, telerehabilitation has become increasingly important worldwide. While the effectiveness of telerehabilitation is considered proven for many indications, there is comparatively little knowledge about the implementation conditions. Therefore, this scoping review summarises the current state of facilitating and inhibiting factors that may influence the uptake of telerehabilitation. The review follows the JBI methodology for scoping reviews. The article search was carried out in five databases (MEDLINE, EMBASE, Web of Science, Cochrane and Psyndex) in May 2022, with an update in October 2023. Two independent researchers identified relevant studies according to the inclusion and exclusion criteria. The Consolidated Framework for Implementation Research served as the theoretical basis for the categorisation of the facilitating and inhibiting criteria in the organisational context. A total of 28 studies (timespan 2012 to 2023) have been included. The most relevant barriers identified are technical issues and a lack of technical skills. The factors considered most favourable for implementation are patients’ motivation and the involvement of high-level leaders. The results provide clear indications of factors that inhibit and facilitate implementation, but also show that further research is needed.

Zusammenfassung: Durch die COVID-19-Pandemie wurden die Rehabilitationseinrichtungen gezwungen, von ihrer Versorgungsroutine abzuweichen und ihre organisatorischen Abläufe den Erfordernissen des Infektionsschutzes anzupassen. In diesem Zuge sind digital unterstützte Rehabilitationsangebote weiterentwickelt und ausgeweitet worden. Ziel der Studie war eine systematische Bestandsaufnahme digital unterstützter Rehabilitationsangebote, inklusive der Erhebung hemmender und förderlicher Faktoren für deren Implementierung.Die bundesweite quantitative Onlineerhebung folgte einem explorativen Ansatz. Anhand eines neu entwickelten Fragebogens, der sich an den Konstrukten des Consolidated Framework for Implementation Research orientiert, wurden in den Fachabteilungen der medizinischen Rehabilitation digital unterstützte Rehabilitationsangebote erfasst sowie hemmende und förderliche Faktoren für deren Implementierung erhoben.452 Fachabteilungen beteiligten sich an der Befragung, von denen zum Zeitpunkt der Studie etwa die Hälfte digital unterstützte Angebote einsetzte. Am häufigsten wurden digitale Schulungen und Tele-Reha-Nachsorge genannt. Hemmende Faktoren für die Implementierung sehen die Antwortenden insbesondere in Arbeitsunterbrechungen durch technische Herausforderungen sowie in einer nicht angemessenen Vergütung durch die Kostenträger. Als besonders förderlich wurden die Unterstützung durch die Führungsebene, die Zweckmäßigkeit des digital unterstützten Angebotes sowie die Einbeziehung der Mitarbeitenden in den Implementationsprozess wahrgenommen.Die Studie gibt erstmals einen Überblick über die in der medizinischen Rehabilitation eingesetzten digital unterstützten Angebote und ermöglicht ein besseres Verständnis der hemmenden und förderlichen Faktoren für deren Implementierung.

Background: Telerehabilitation has become increasingly important worldwide, as the COVID-19 pandemic forced many rehabilitation centers to change their daily care routine and find new ways to provide medical rehabilitation and aftercare. Objective: This study aims to investigate the acceptance and implementation conditions of telerehabilitation in Germany, particularly following the COVID-19 pandemic. Methods: We conducted qualitative semistructured interviews with patients (n=9) and health care professionals (n=8) between September 2023 and January 2024. To explore individual and structural barriers to and facilitators of telerehabilitation adoption, we used the extended unified theory of acceptance and use of technology and the Consolidated Framework for Implementation Research. Results: Patients and health care professionals perceived telerehabilitation as positive, mainly due to its flexibility and accessibility. Patients expressed high acceptance levels, anticipating health benefits, although they found it challenging to familiarize themselves with the technology and establish routines. Health care professionals highlighted the need for adequate resources (financial, time, and personnel) and management support to implement telerehabilitation successfully. Both groups saw higher acceptance and cost coverage of telerehabilitation services as essential for successful implementation and use in Germany. Conclusions: This study identified institutional barriers, such as concerns about resource availability, team communication, and initial resistance among health care staff to the introduction of new technologies. At an individual level, we found that patients struggled with routine establishment and that digital and in-person support from institutions and peers could mitigate this challenge. Implementing a hybrid approach and improving funding and approval processes would enhance telerehabilitation integration in the German health care sector.

BACKGROUND Telerehabilitation has become increasingly important worldwide, as the COVID-19 pandemic forced many rehabilitation centers to change their daily care routine and find new ways to provide medical rehabilitation and aftercare. OBJECTIVE This study aims to investigate the acceptance and implementation conditions of telerehabilitation in Germany, particularly following the COVID-19 pandemic. METHODS We conducted qualitative semistructured interviews with patients (n=9) and health care professionals (n=8) between September 2023 and January 2024. To explore individual and structural barriers to and facilitators of telerehabilitation adoption, we used the extended unified theory of acceptance and use of technology and the Consolidated Framework for Implementation Research. RESULTS Patients and health care professionals perceived telerehabilitation as positive, mainly due to its flexibility and accessibility. Patients expressed high acceptance levels, anticipating health benefits, although they found it challenging to familiarize themselves with the technology and establish routines. Health care professionals highlighted the need for adequate resources (financial, time, and personnel) and management support to implement telerehabilitation successfully. Both groups saw higher acceptance and cost coverage of telerehabilitation services as essential for successful implementation and use in Germany. CONCLUSIONS This study identified institutional barriers, such as concerns about resource availability, team communication, and initial resistance among health care staff to the introduction of new technologies. At an individual level, we found that patients struggled with routine establishment and that digital and in-person support from institutions and peers could mitigate this challenge. Implementing a hybrid approach and improving funding and approval processes would enhance telerehabilitation integration in the German health care sector.