Telerehabilitation Technology Used for Remote Wrist/Finger Range of Motion Evaluation: A Scoping Review

Abstract

Background: Monitoring finger/wrist range of motion (ROM) is an important component of routine hand therapy after surgery. Telerehabilitation is a field that may potentially address various barriers of in-person hand therapy appointments. Therefore, the purpose of this scoping review is to identify telerehabilitation technologies that can be feasibly used in a patient's home to objectively measure finger/wrist ROM.

Methods: Following PRISMA-ScR guidelines for scoping reviews, we systematically searched MEDLINE and Embase electronic databases using alternative word spellings for the following core concepts: "wrist/hand," "rehabilitation," and "telemedicine." Studies were imported into Covidence, and systematic two-level screening was done by two independent reviewers. Patient demographics and telerehabilitation information were extracted from the selected articles, and a narrative synthesis of the findings was done.

Results: There were 28 studies included in this review, of which the telerehabilitation strategies included smartphone angle measurement applications, smartphone photography, videoconference, and wearable or external sensors. Most studies measured wrist ROM with the most accurate technologies being wearable and external sensors. For finger ROM, the smartphone angle application and photography had higher accuracy than sensor systems. The telerehabilitation strategies that had the highest level of usability in a remote setting were smartphone photographs and estimation during virtual appointments.

Conclusions: Telerehabilitation can be used as a reliable substitute to in-person goniometer measurements, particularly the smartphone photography and motion sensor ROM measurement technologies. Future research should investigate how to improve the accuracy of motion sensor applications that are available on easy-to-access devices.

Fig. 1.

PRISMA flow diagram for systematic reviews illustrating search results.

Fig. 2.

A stacked bar graph illustrating the number of studies based on telerehabilitation technology used and the joint ROM examined.

Fig. 3.

A bar graph illustrating the number of studies that had poor, moderate, good, or excellent ICC comparing technologies with gold standard goniometer measurements, based on technology and jointly measured for each study. Poor ICC values are considered values below 0.5, moderate is between 0.5 and 0.75, good reliability is between 0.75 and 0.9, and excellent reliability is above 0.9.