Digitising Creative Psychological Therapy

In response to the COVID-19 pandemic, there has been a need to adapt and develop psychological interventions that address the mental health of those in need. As a result, Arts for the Blues (A4B), an evidence-based creative group psychotherapy model, originally developed for in-person delivery to address the needs of clients with depression, was transformed into a remote therapy option. This chapter presents an overview of plans and steps so far and offers activities used online during a public workshop with 24 participants and training sessions with 70 psychotherapists (qualified and trainee). Concerns around safety, group sizes, time, and guidance/support are discussed, while the value of online work for clients with depression (adults and children) are explored. It is concluded that even when in-person delivery is possible, online versions will be useful since they encourage a wider reach and make interventions more accessible.

Physiotherapists’ use and perceptions of digital remote physiotherapy during COVID-19 lockdown in Switzerland: an online cross-sectional survey

Background The Swiss containment strategy for the COVID-19 pandemic during the first wave in spring 2020 resulted in a moratorium on non-urgent physiotherapy via regular direct patient contact. Consequently, such physiotherapy sessions declined by 84%. This study investigates the impact of this moratorium on the use of digital remote physiotherapy in Switzerland during this period and the perceptions of its use by Swiss physiotherapists (PTs). Methods A cross-sectional online questionnaire was distributed between June and August of 2020 via the Swiss Physiotherapy Association (physioswiss) and various associations of physiotherapy specialists (e.g., sport, pediatric) working in both inpatient and outpatient settings. The questionnaire was designed to capture the demographics of participants and the perceptions of PTs using 33 questions in the following domains: Demography; Attitudes towards digital technology; Private and professional use of digital technology; Use of digital technology during therapy; and, Support requirements. Closed and open-ended questions were included and the frequency of answers was analyzed. Non-parametric inferential statistics were used to identify differences, where appropriate. The Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was adopted. Results Participants in the survey were 742 PTs (23.5% male, mean age of 43 years, mean working experience of 18 years) from the German-speaking (75.5%), French-speaking (15.1%), and Italian-speaking (9.4%) regions of Switzerland. The percentage of PTs using digital remote therapy increased from 4.9% prior to the lockdown to 44.6% during the lockdown period. The majority of PTs did not consider that digital remote therapy could complement usual physiotherapy practice and did not plan to continue with digital remote therapy after the pandemic. Conclusions During the lockdown, Swiss PTs adopted various low-cost and easily accessible digital technologies. However, several barriers hampered further implementation of this modality. Specific education and training programs need to be provided among PTs, appropriate digital technologies should be introduced, and a correct reimbursement scheme should be developed. Trial registration COVIDPhysio Registry of World Physiotherapy, registered 15th June 2020 (https://world.physio/covid-19-information-hub/covid-19-covidphysio-registry).

Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011–2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities.

Home-based telerehabilitation: A review of remote therapy frameworks

Remote therapy frameworks play the main role in home-based telerehabilitation. These remote therapies are exergames that help in the physical and cognitive rehabilitation of the patient. The objective of this review is to present the frameworks of home-based therapies using exergames and to identify the points that can be improved in the development of future systems. To carry out this research, the criteria of the PRISMA were adopted. Literature searches were conducted up to April 2021 in the Web of Sicence, Pubmed, Cochrane, Embase and Scopus databases. The search query was: (("game*" OR "exergame*") AND ("rehabilitation") AND ("remote" OR "telerehabilitation" OR "telemedicine")). We have selected a total of fourteen studies. We found five types of frameworks: Client-Server, Web-Based, Layers, Cloud Based and Multi users. We identified that it may be advantageous to mix the features of these frameworks to have a cheaper home-based system and prevent the patient from having to purchase more powerful computers. In addition, there are some challenges that need to be studied that will also help reduce costs for the patient: 1) Reduce the need for high processing of exergames on the patient's computer; 2) Prevent the patient from having to purchase expensive external devices for motion tracking.

Remote W.A.R.A. Compared With Face-to-Face W.A.R.A.: A Pilot Study

BackgroundSince the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online.MethodsWe assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design.ResultsW.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001).LimitationsThe major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing “unpleasant feelings.” This conceptualization of negative affect might still be a point of discussion.ConclusionThe study’s findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.