Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review

Abstract

Background: In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations.

Objective: This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care.

Methods: We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes.

Results: After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain.

Conclusions: Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.

Keywords: clinical medicine; embodied conversational agent; health behavior; physical activity; rehabilitation; review; virtual coaching.

Figure 1

Flowchart describing study's identification and selection.

Figure 2

Included articles versus years.

Figure 3

On left: number of studies (randomized controlled trial or exploratory) versus interface modalities. On right: some examples of embodied conversational agents (ECAs) reported in the selected articles: (a) Friederichs et al 2014, (b) Tielman et al 2017, (c) Stevens et al 2016, (d) de Rosis et al 2006, Novielli et al 2012, (e) Bickmore et al 2013a, Ellis et al 2013.

Figure 4

Number of studies (randomized controlled trial or exploratory) versus clinical conditions.