Dahlia Kairy

Background: The efficacy and acceptability of remote care have now been demonstrated for many musculoskeletal disorders (MSKDs). However, the acceptability and potential uses of an initial remote evaluation for MSKDs have been scarcely studied and may be lower because of the loss of physical contact during the physical examination. Objective: To explore the use of telehealth for the initial evaluation of MSKDs in France and to provide an in‐depth understanding of its application, benefits and barriers. Methods: Twenty‐nine semi‐structured interviews were conducted in France with patients, healthcare providers (family physicians, musculoskeletal medical specialists and physiotherapists), professional body representatives and telehealth software specialists. Five tailored interview guides adapted from a previous qualitative study were used. All interviews were transcribed verbatim and a reflexive thematic analysis was performed. Results: Participants found initial remote evaluations innovative for improving access but disagreed on the optimal scope and use. Four key themes were identified: (1) remote evaluation as a continuum from triage to diagnosis, conditioned by the perceived validity and feasibility of the adapted physical examination; (2) telehealth can complicate the patient–provider relationship; (3) videoconferencing is common, but its use in medical consultations may increase workload and burden; and (4) unlocking the full potential of telehealth requires coordinated planning and action as well as system‐level support. Conclusions: Participants consistently identified remote triage as an acceptable initial stage in implementing remote evaluations for patients with MSKDs. Successful implementation will likely require targeted support for both patients and healthcare providers in conducting remote evaluations.

This community-engaged qualitative study co-defined digital health and artificial intelligence (AI) priorities with First Nations communities in Manitoba, Canada, including those with disabilities. Grounded in Indigenous research methodologies and community-based participatory research, the project responded to persistent inequities in rehabilitation and health service access shaped by geography, colonial legacies, and jurisdictional fragmentation. These inequities are especially important in the context of aging, as older adults and Elders may experience compounded barriers related to disability, chronic conditions, mobility limitations, and digital exclusion. Over approximately 12 months, an interdisciplinary team consisting of First Nations scholars and partners, disability organizations, clinicians, and researchers conducted relationship-building visits and meetings with First Nations leadership, Elders/Knowledge Keepers, health providers, and community members to inform the design of a Gathering focused on disability, digital health, and AI. A one-day community-engaged Gathering was held on Treaty 1 and 2 Territory in Winnipeg and convened approximately 70 participants from multiple First Nations communities and disability/health organizations. Five facilitated roundtables explored: (1) health and research priorities for First Nations persons with disabilities; (2) primary care and disabilities; (3) digital access and cultural safety; (4) culturally safe and ethical AI use; and (5) health system challenges, disability, and digital health. Data consisted of facilitator-produced, de-identified table summaries, facilitator reflection forms, and participant-validated plenary notes; no recordings or individual sociodemographic data were collected. Using qualitative description and team-based content analysis, three interrelated domains emerged: (1) relationships, identity, trust, and cultural safety; (2) system, infrastructure, and equity conditions required for accessible care and digital inclusion (e.g., connectivity “dead zones,” device access, transport, and culturally safe services); and (3) opportunities, risks, and governance principles for AI and data use (e.g., AI literacy, privacy, bias, Indigenous data sovereignty, and Nation-specific governance). Findings emphasize that equitable digital health and AI must be relational, disability-informed, culturally safe, and led under First Nations authority, with AI positioned to support, rather than replace, human care relationships. The findings also highlight the importance of designing digital health and AI initiatives that remain accessible and trustworthy for older adults and Elders, particularly where aging, disability, and rural or remote living intersect.

Falls among older adults are a major public health concern. Older adults living in low-income housing (LIH) are at higher risk of falls due to disadvantages linked to social determinants of health, yet remain underrepresented in research. This study aimed to assess the feasibility of a program addressing fear of falling and its consequences on activity levels among older adults living in LIH in Côte-des-Neiges (Montreal, QC, Canada). A mixed-methods pilot feasibility study was conducted using Bowen et al.’s framework, drawing on data collected through questionnaires, observation grids, attendance records, and semi-structured interviews. The program consisted of six 90 min sessions designed to enhance participants’ confidence in preventing falls while promoting engagement in activities. Fourteen older adults (mean age = 75.5 years) were recruited. Outcome data on fall-related psychological factors, activity engagement, and knowledge about falls were collected before and after the program. Moreover, older participants’ perceived benefits were assessed following program completion. Post-program interviews with older adults, facilitators, and a community field worker were conducted to further explore program feasibility, including its acceptability, implementation, and integration. The program showed strong acceptability and a high attendance rate (95%). Although no statistically significant pre-post changes were observed in the outcome variables, older participants reported several benefits at post-test, including improved knowledge about fall prevention (100%) and greater confidence in their ability to avoid falls (85%). These findings support the feasibility of implementing this culturally adapted fall prevention program in similar LIH settings and provide valuable insights for its refinement and future research. Further investigation is warranted to examine the program’s feasibility across other LIH settings and linguistic groups, as well as to assess its effectiveness.

Background Precision health approaches aim to predict, deliver and optimize the right intervention, at the right time, for the right person. While precision medicine is well-established, its application in rehabilitation remains nascent. This study aimed to 1) Map the state of knowledge on precision rehabilitation by describing the extent, scope and nature of the literature, identifying similarities and differences with precision medicine, and describing the role of technologies and artificial intelligence (AI); 2) Describe knowledge users’ perspectives on precision rehabilitation; and 3) Integrate quantitative and qualitative results to develop a working definition of precision rehabilitation. Methods A convergent mixed-methods design was used to conduct a scoping review with a qualitative consultation phase. The scoping review followed Johanna Briggs Institute methodological recommendations and PRISMA-ScR reporting guidelines. Five databases were searched for adjacent keywords ‘precision’ AND ‘rehabilitation’. Data were extracted and analyzed descriptively and thematically. In parallel, individual interviews were conducted with knowledge users at three North American rehabilitation centers. Transcripts were analyzed using deductive content analysis. Mixed method integration synthesized and contrasted literature-derived and knowledge users-derived insights. Results Forty-nine articles met inclusion criteria; 26 (53%) were primary research studies, while 23 (47%) were non-empirical publications. Amongst research studies, 14 (54%) involved technology use, while 5 (19%) used AI. Seven (14%) articles included a definition of precision medicine, while 22 (45%) included a definition of precision rehabilitation. Interviews with 16 knowledge users highlighted that personalization is uniquely expressed in precision rehabilitation as compared to medicine and identified rehabilitation-specific facilitators and barriers to precision approaches. Data integration confirmed that a focus on function differentiates precision approaches in rehabilitation from medicine, clarified rehabilitation-specific logistical barriers to technology-enabled data collection in precision approaches, and attributed limited AI use to concerns about predictions based solely on data that excludes psychosocial factors and population heterogeneity. Conclusions Results indicate greater similarities than differences between precision approaches in rehabilitation and medicine, while highlighting rehabilitation’s emphasis on personalization, function and participation. Findings identify key barriers and facilitators and support a proposed definition of precision rehabilitation for further refinement through peer consensus to accompany advances in research and clinical practice.

Purpose: Many older women experience urinary incontinence (UI). However, access to pelvic floor muscle (PFM) training, an effective first-line treatment, is limited. Group-based telerehabilitation appears cost-effective and could improve accessibility. Recent evidence suggests a group-based PFM telerehabilitation programme for treating UI in older women (teleGROUP) is feasible and clinically relevant. This qualitative study assessed teleGROUP’s acceptability to both patients and a clinician. Method: Thirty-three older women who completed the teleGROUP programme, and the physiotherapist who led it, discussed their experiences in focus groups or interviews. We transcribed qualitative data and analyzed them using thematic analysis. Results: Participating women enhanced self-efficacy in managing symptoms and contracting PFMs, reporting high self-efficacy in attending sessions and completing home exercises. The programme fostered positive affective attitudes in participants and the physiotherapist, aligned with their values, and improved self-efficacy with technology. Participants and the physiotherapist perceived clinical effectiveness as high. Women identified time commitment as a burden; the physiotherapist found time management challenging. However, the women found remote participation convenient. They recognized that PFM exercises led to symptom improvement. Conclusion: The programme proved acceptable for older women and the physiotherapist. Pragmatic trials in real-life clinical settings and implementation studies are necessary for further validation.

Background: Although traditional rehabilitation methods are effective in promoting recovery for patients with disabilities, some approaches can involve repetitive tasks, making it challenging to maintain high patient engagement and adherence. This can impact the amount of therapy patients receive, which can sometimes limit their overall recovery potential, particularly given constraints in healthcare resources. Extended reality (XR) technologies, which include virtual reality (VR) and augmented reality (AR), offer promising benefits to personalize care and enhance rehabilitation and engagement by increasing motivation and engagement through interactive and immersive environments. Despite these promising advantages, their successful integration in clinical practice has remained limited, partly due to lack of early involvement of clinicians and end-users in the development process. Objective: We aim to provide recommendations for XR rehabilitation technology development, including researchers and industry professionals, to foster more personalized, adoptable and effective tools for patients with neuromusculoskeletal disorders in a clinical setting. Methods: Principles from motor control and game theory are used to describe key features and recommendations for XR rehabilitation technology development to optimize rehabilitation applications in a clinical setting. These recommendations stem from established motor learning and game design principles, a state-of-the-art narrative review of emerging XR rehabilitation literature (2015–2025) and insights from the Ensemble! Program, a living lab where clinicians, researchers, and patients collaborate to explore emerging technologies, including but not limited to serious games using XR technologies. Results: Key design recommendations include strategies for supporting patient motivation, adjusting game difficulty, providing feedback and handling data collection. Conclusions: Integrating motor control and game theory principles into XR rehabilitation technology can help optimize its therapeutic effectiveness and clinical applicability for patients with neuromusculoskeletal conditions. By addressing clinician and patient needs early in the development process, these technologies can be better tailored to meet therapeutic goals and facilitate broader adoption in clinical practice.

Background/Objectives: Speech and language pathologists (SLPs) may use telerehabilitation (TR) to assess, diagnose, and treat disorders of speech, language, and swallowing. Many clinicians pivoted from in-person practice to TR during the COVID-19 pandemic. This rapid review aims to explore equity considerations regarding the use of TR for SLP and how clinicians’ attitudes towards TR changed before and after the COVID-19 pandemic. Of special interest is how access to services and technology was influenced by geography and for marginalized patients. Methods: A rapid review of reviews protocol was developed, and articles were analyzed in two timespans to capture data before and during the pandemic (January 2010 to July 2020 and August 2020 to December 2023). Literature was included which included SLP clinical practice, involving TR, written in English or French. Titles and abstracts were screened, and data was extracted following full-text review. Validation and conflicts were resolved continuously with team members. Results: The reviewed literature (n=54) showed that SLP services delivered via TR can be used to reduce barriers for marginalized populations who live in remote and rural areas, without SLP services or services in one’s first language, or for those with mobility challenges which restrict travel to face-to-face appointments. Conclusions: This review highlights that TR can reduce barriers for access to SLP services for remote and rural locations, areas without local specialty SLP coverage, service in one’s first language, or those with mobility challenges.

Background: Telerehabilitation (TR) has been increasingly used to deliver psychological and neuropsychological care remotely, especially since the COVID-19 pandemic. As health services continue to shift toward telehealth, ensuring ethical and equitable TR delivery is essential to establish sustainable TR models. Objective: The objective of this review is to synthesize existing evidence on the ethical and equity-related benefits and pitfalls associated with the use of TR in a psychological and neuropsychological context for individuals with physical disabilities. Methods: This rapid review included reviews (2010–2020) and original studies (2020–2023) that focused on TR interventions for people with physical disabilities in the context of psychology and neuropsychology rehabilitation. Results: A total of 16 reviews and 82 original articles were included. Key ethical concerns centered around privacy, confidentiality, caregiver burden, and clinician-patient relationship quality. Equity concerns centered around access disparities (e.g., geographic location, income), digital literacy, and demographic underrepresentation. Conclusion: This review is part of a pan-Canadian initiative aimed at informing policy development and clinical practice in TR. Findings highlight the need for clear guidelines and targeted interventions to ensure that TR in psychology and neuropsychology is both ethically sound and equitable.

Extended reality (XR) and telerehabilitation (TR) technologies are increasingly being used into stroke rehabilitation. These technologies have the potentia