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    ChatGPT as an Information Source for Patients with Migraines: A Qualitative Case Study
    Migraines are one of the most common and expensive neurological diseases worldwide. Non-pharmacological and digitally delivered treatment options have long been used in the treatment of migraines. For instance, migraine management tools, online migraine diagnosis or digitally networked patients have been used. Recently, applications of ChatGPT are used in fields of healthcare ranging from identifying potential research topics to assisting professionals in clinical diagnosis and helping patients in managing their health. Despite advances in migraine management, only a minority of patients are adequately informed and treated. It is important to provide these patients with information to help them manage the symptoms and their daily activities. The primary aim of this case study was to examine the appropriateness of ChatGPT to handle symptom descriptions responsibly, suggest supplementary assistance from credible sources, provide valuable perspectives on treatment options, and exhibit potential influences on daily life for patients with migraines. Using a deductive, qualitative study, ten interactions with ChatGPT on different migraine types were analyzed through semi-structured interviews. ChatGPT provided relevant information aligned with common scientific patient resources. Responses were generally intelligible and situationally appropriate, providing personalized insights despite occasional discrepancies in interaction. ChatGPT’s empathetic tone and linguistic clarity encouraged user engagement. However, source citations were found to be inconsistent and, in some cases, not comprehensible, which affected the overall comprehensibility of the information. ChatGPT might be promising for patients seeking information on migraine conditions. Its user-specific responses demonstrate potential benefits over static web-based sources. However, reproducibility and accuracy issues highlight the need for digital health literacy. The findings underscore the necessity for continuously evaluating AI systems and their broader societal implications in health communication.
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    Developing a competency model for telerehabilitation therapists and patients: Results of a cross-sectional online survey
    Telerehabilitation is a new form of care that provides digital access to rehabilitative services. However, it places many demands on the users–both patients and therapists. The aim of this study was to determine the requirements and competencies needed for successful usage, identify person- and context-specific differences and develop a competency model. We conducted two cross-sectional online surveys with telerehabilitation patients and therapists from Germany during June-August 2023. The adjusted dataset of 262 patients and 73 therapists was quantitatively analyzed including descriptive and bivariate statistics. Group differences were assessed using t-tests or U-tests. The development of two telerehabilitation competency models was guided by a competency modeling process. The surveys show that patients need to gather program information before program start, follow therapist’s instructions, adapt therapy, deal with health problems, as well as motivate and remind oneself during the program. Therapists need to inform and instruct patients, adapt therapy, carry out technical set-up and support, give medical support, guide and monitor patients, give feedback, motivation and reminder, as well as documentation. The competency model for patients includes 23 and the model for therapists 24 core competencies, including various required areas of knowledge, skills, attitudes and experiences. The three most relevant competencies for patients are self-interest in the program, self-awareness and self-management. Also, disease severity, age, and language abilities can enable successful execution. Program type, technology affinity, and age significantly influence the rated relevance of competencies. The three most relevant competencies for therapists are therapeutic-professional skills, medical and telerehabilitation knowledge. The type of therapy practiced and language abilities can enable successful execution. Therapist’s age, technology affinity, and job type significantly impact the rated relevance. The models should be applied to develop tailored training formats and support decisions on the selection of suitable therapists and patients for telerehabilitation.
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      2
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    Factors Facilitating and Inhibiting the Implementation of Telerehabilitation—A Scoping Review
    Due to the coronavirus pandemic, telerehabilitation has become increasingly important worldwide. While the effectiveness of telerehabilitation is considered proven for many indications, there is comparatively little knowledge about the implementation conditions. Therefore, this scoping review summarises the current state of facilitating and inhibiting factors that may influence the uptake of telerehabilitation. The review follows the JBI methodology for scoping reviews. The Article search was carried out in five databases (MEDLINE, EMBASE, Web of Science, Cochrane and Psyndex) in May 2022, with an update in October 2023. Two independent researchers identified relevant studies according to the inclusion and exclusion criteria. The Consolidated Framework for Implementation Research served as the theoretical basis for the categorisation of the facilitating and inhibiting criteria in the organisational context. A total of 28 studies (timespan 2012 to 2023) have been included. The most relevant barriers identified are technical issues and a lack of technical skills. The factors considered most favourable for implementation are patients’ motivation and the involvement of high-level leaders. The results provide clear indications of factors that inhibit and facilitate implementation, but also show that further research is needed.
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    Virtual Reality for Upper Extremity Rehabilitation—A Prospective Pilot Study
    Applications related to virtual reality are a rapidly growing area. Thus, these technologies are also increasingly used in the field of medicine and rehabilitation. The primary objective of this prospective pilot study was to investigate the feasibility, user experience and acceptance of a virtual-reality-based system for upper extremity rehabilitation. The study was conducted as a single-center trial over 16 weeks. The eligibility criteria included rehabilitants with upper extremity injuries of at least 18 years of age who were fluent in spoken and written German. After detailed instruction, each participant was asked to complete daily 30 min exercises over 15 training sessions with the virtual reality system consisting of three different training modules. Outcomes were assessed pre-study and post-study using standardized clinical measures. In addition, qualitative interviews with rehabilitants as well as therapists regarding user experience and acceptance were conducted. Six participants were recruited for the pilot study, of which five underwent virtual-reality-based rehabilitation. Overall, the clinical measures showed a positive tendency over the course of the study, even if the results were not significant. Furthermore, the virtual-reality-based training was well accepted by the participants as well as therapists. Given these findings, it will be beneficial to evaluate virtual reality for rehabilitation in further research.
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