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Brennan, Louise
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Brennan, Louise
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Brennan, Louise
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- PublicationConceptualising a Targeted Rehabilitation Exercise Biofeedback System for a Cancer Survivorship PopulationIntroduction The increased prevalence of cancer survivors requires a focus on developing long-term, cost-effective management strategies to prevent and limit disability and morbidity. Background Cancer survivors with pain, weakness and restricted movement often benefit from targeted exercise programmes provided by a Physiotherapist. Physical, psychological and situational factors can impact on patients abilities to complete these exercises. In recent years, interactive biofeedback exercise systems have been shown to be effective in the rehabilitation of musculoskeletal impairments. Such a system has not yet been developed for cancer survivors. Proposal An targeted rehabilitation exercise biofeedback system for use in cancer survivors is proposed. This system aims to enhance rehabilitation outcomes using biofeedback, gamification and adherence promotion strategies. Conclusion An online targeted-exercise biofeedback system for use in cancer rehabilitation would be an innovative, beneficial development for the growing numbers of individuals surviving cancer.
276 - PublicationPatient Experiences of Rehabilitation and the Potential for an mHealth System with Biofeedback After Breast Cancer Surgery: Qualitative StudyBACKGROUND: Physiotherapy-led home rehabilitation after breast cancer surgery can protect against the development of upper limb dysfunction and other disabling consequences of surgery. A variety of barriers can limit physical rehabilitation outcomes, and patients may benefit from more support during this time. Mobile health (mHealth) systems can assist patients during rehabilitation by providing exercise support, biofeedback, and information. Before designing mHealth systems for a specific population, developers must first engage with users to understand their experiences and needs. OBJECTIVE: The aims of this study were to explore patients' rehabilitation experiences and unmet needs during home rehabilitation after breast cancer surgery and to understand their experiences of mHealth technology and the requirements they desire from an mHealth system. METHODS: This was the first stage of a user-centered design process for an mHealth system. We interviewed 10 breast cancer survivors under the two main topics of "Rehabilitation" and "Technology" and performed a thematic analysis on the interview data. RESULTS: Discussions regarding rehabilitation focused on the acute and long-term consequences of surgery; unmet needs and lack of support; self-driven rehabilitation; and visions for high-quality rehabilitation. Regarding technology, participants reported a lack of mHealth options for this clinical context and using non-cancer-specific applications and wearables. Participants requested an mHealth tool from a reliable source that provides exercise support. CONCLUSIONS: There are unmet needs surrounding access to physiotherapy, information, and support during home rehabilitation after breast cancer surgery that could be addressed with an mHealth system. Breast cancer survivors are open to using an mHealth system and require that it comes from a reliable source and focuses on supporting exercise performance.
272Scopus© Citations 15 - PublicationFeedback Design in Targeted Exercise Digital Biofeedback Systems for Home Rehabilitation: A Scoping ReviewDigital biofeedback systems (DBSs) are used in physical rehabilitation to improve outcomes by engaging and educating patients and have the potential to support patients while doing targeted exercises during home rehabilitation. The components of feedback (mode, content, frequency and timing) can influence motor learning and engagement in various ways. The feedback design used in DBSs for targeted exercise home rehabilitation, as well as the evidence underpinning the feedback and how it is evaluated, is not clearly known. To explore these concepts, we conducted a scoping review where an electronic search of PUBMED, PEDro and ACM digital libraries was conducted from January 2000 to July 2019. The main inclusion criteria included DBSs for targeted exercises, in a home rehabilitation setting, which have been tested on a clinical population. Nineteen papers were reviewed, detailing thirteen different DBSs. Feedback was mainly visual, concurrent and descriptive, frequently providing knowledge of results. Three systems provided clear rationale for the use of feedback. Four studies conducted specific evaluations of the feedback, and seven studies evaluated feedback in a less detailed or indirect manner. Future studies should describe in detail the feedback design in DBSs and consider a robust evaluation of the feedback element of the intervention to determine its efficacy.
307Scopus© Citations 23 - PublicationBiofeedback in Breast Cancer Rehabilitation: Applying the WHO ICF Core Set to Identify Opportunities and RecommendationsDigital biofeedback technologies are used in physical rehabilitation to improve motor learning and enhance engagement with therapies, but they are unfrequently used in breast cancer rehabilitation. Digital biofeedback interventions should be custom-made for the specific breast cancer context. The WHO ICF Core Set for Breast Cancer describes this context by itemising the biopsychosocial and environmental factors associated with breast cancer. We analysed this Core Set to identify opportunities for biofeedback intervention, and to make recommendations for successful, inclusive design of digital biofeedback interventions in breast cancer rehabilitation. Impairments of strength, joint movement and upper limb function present opportunities for the development of digital biofeedback interventions. Factors related to sensory loss, lymphoedema, chemotherapy-related cognitive dysfunction and fatigue should be considered when designing and evaluating biofeedback systems.
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