MSK – Muskuloskelettale Physiotherapie 2024; 28(04): 209-216
DOI: 10.1055/a-2344-7769
Schwerpunkt | Einführung

Smart Physiotherapy: Wie die Digitalisierung die Physiotherapie verändern wird

Angela Arntz
,
Franziska Weber
,
Christian Grüneberg

Die Zukunft der Digitalisierung in der Physiotherapie scheint vielversprechend und könnte zu einer besseren Patient*innenversorgung führen. In den kommenden Jahren werden sehr wahrscheinlich digitale Tools wie Apps, Wearables, Videokonferenzsysteme und Künstliche Intelligenz in der täglichen Praxis regelmäßig eingesetzt werden. Ein Überblick über Begrifflichkeiten, die Anwendung digitaler Technologien, die Gesetzgebung sowie notwendige Voraussetzungen, damit das Zukunftsversprechen eingelöst werden kann.



Publication History

Article published online:
13 September 2024

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  • Literatur

  • 1 Darkins AW, Cary MA. Telemedicine and Telehealth. Principles, Policies, Performances and Pitfalls. Springer Publishing Company; 2000
  • 2 Shaw T, McGregor D, Brunner M. et al. What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants. J Med Internet Res 2017; 19: e324 DOI: 10.2196/jmir.8106.
  • 3 Brennan D, Tindall L, Theodoros D. et al. A blueprint for telerehabilitation guidelines. Int J Telerehabil 2010; 2: 31-34 DOI: 10.5195/ijt.2010.6063.
  • 4 Bashshur R, Shannon G, Krupinski E. et al. The Taxonomy of Telemedicine. Telemed J E Health 2011; 17: 484-494 DOI: 10.1089/tmj.2011.0103.
  • 5 Dear BF, Gandy M, Karin E. et al. The Pain Course: a randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support. PAIN 2015; 156: 1920-1935 DOI: 10.1097/j.pain.0000000000000251.
  • 6 Lorig KR, Ritter PL, Laurent DD. et al. The internet-based arthritis self-management program: A one-year randomized trial for patients with arthritis or fibromyalgia. Arthritis Rheum 2008; 59: 1009-1017 DOI: 10.1002/art.23817.
  • 7 Mallari B, Spaeth EK, Goh H. et al. Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis. J Pain Res 2019; 12: 2053-2085 DOI: 10.2147/JPR.S200498.
  • 8 Weber F, Müller C, Bahns C. et al. Smartphone-assisted training with education for patients with hip and/or knee osteoarthritis (SmArt-E): study protocol for a multicentre pragmatic randomized controlled trial. BMC Musculoskelet Disord 2023; 24: 221 DOI: 10.1186/s12891-023-06255-7.
  • 9 Weber F, Kloek C, Arntz A. et al. Blended Care in Patients With Knee and Hip Osteoarthritis in Physical Therapy: Delphi Study on Needs and Preconditions. JMIR Rehabil Assist Technol 2023; 10: e43813 DOI: 10.2196/43813.
  • 10 Wentzel J, van der Vaart R, Bohlmeijer ET. et al. Mixing Online and Face-to-Face Therapy: How to Benefit From Blended Care in Mental Health Care. JMIR Ment Health 2016; 3: e9 DOI: 10.2196/mental.4534.
  • 11 Gesellschaft für Versicherungswissenschaft und -gestaltung. Versorgung 2030 - eHealth, mHealth, Telemedizin: Bedeutung, Perspektiven und Entwicklungsstand: GVG; 2015
  • 12 Gigerenzer G, Schlegel-Matthies K, Wagner GG. et al. Digitale Welt und Gesundheit: eHealth und mHealth - Chancen und Risiken der Digitalisierung im Gesundheitsbereich: Januar 2016: Berlin: Sachverständigenrat für Verbraucherfragen beim Bundesministerium der Justiz und für Verbraucherschutz; 2016
  • 13 Bundesministerium für Gesundheit (BMG). Glossar: E-Health Im Internet: https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/e/e-health; Stand: 12.03.2024
  • 14 Cottrell MA, Russell TG. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract 2020; 48: 102193 DOI: 10.1016/j.msksp.2020.102193.
  • 15 Arntz A, Weber F, Handgraaf M. et al. Technologies in Home-Based Digital Rehabilitation: Scoping Review. JMIR Rehabil Assist Technol 2023; 10: e43615 DOI: 10.2196/43615.
  • 16 Kaczorowski S, Donath L, Owen PJ. et al. Telemedicine for Patients with Musculoskeletal Pain Lacks High-Quality Evidence on Delivery Modes and Effectiveness: An Umbrella Review. Telemed J E Health 2024; 30: 1221-1238 DOI: 10.1089/tmj.2023.0255.
  • 17 Bargeri S, Castellini G, Vitale JA. et al. Effectiveness of Telemedicine for Musculoskeletal Disorders: Umbrella Review. J Med Internet Res 2024; 26: e50090 DOI: 10.2196/50090.
  • 18 Du S, Liu W, Cai S. et al. The efficacy of e-health in the self-management of chronic low back pain: A meta analysis. Int J Nurs Stud 2020; 106: 103507 DOI: 10.1016/j.ijnurstu.2019.103507.
  • 19 Lara-Palomo IC, Gil-Martínez E, Ramírez-García JD. et al. Efficacy of e-Health Interventions in Patients with Chronic Low-Back Pain: A Systematic Review with Meta-Analysis. Telemed J E Health 2022; 28: 1734-1752 DOI: 10.1089/tmj.2021.0599.
  • 20 Safari R, Jackson J, Sheffield D. Digital Self-Management Interventions for People With Osteoarthritis: Systematic Review With Meta-Analysis. J Med Internet Res 2020; 22: e15365-e15365 DOI: 10.2196/15365.
  • 21 Xie S-H, Wang Q, Wang L-Q. et al. Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2021; 23: e21542 DOI: 10.2196/21542.
  • 22 Du S, Hu L, Dong J. et al. Self-management program for chronic low back pain: A systematic review and meta-analysis. Patient Educ Couns 2017; 100: 37-49 DOI: 10.1016/j.pec.2016.07.029.
  • 23 Yang Y, Li S, Cai Y. et al. Effectiveness of telehealth-based exercise interventions on pain, physical function and quality of life in patients with knee osteoarthritis: A meta-analysis. J Clin Nurs 2023; 32: 2505-2520 DOI: 10.1111/jocn.16388.
  • 24 Simpson L, Maharaj MM, Mobbs RJ. The role of wearables in spinal posture analysis: a systematic review. BMC Musculoskelet Disord 2019; 20: 55 DOI: 10.1186/s12891-019-2430-6.
  • 25 Papi E, Koh WS, McGregor AH. Wearable technology for spine movement assessment: A systematic review. J Biomech 2017; 64: 186-197 DOI: 10.1016/j.jbiomech.2017.09.037.
  • 26 Hodges PW, Van Den Hoorn W. A vision for the future of wearable sensors in spine care and its challenges: narrative review. J Spine Surg 2022; 8: 103-116 DOI: 10.21037/jss-21-112.
  • 27 Truong MX. Mobile Application Development: Definition, Technologies, Costs and Benefits. (15/03/2021). Im Internet: https://magenest.com/en/mobile-application-development/; Stand: 15.07.2024
  • 28 Chen Y, Yu Y, Lin X. et al. Intelligent Rehabilitation Assistance Tools for Distal Radius Fracture: A Systematic Review Based on Literatures and Mobile Application Stores. Comput Math Methods Med 2020; 2020: 761359 DOI: 10.1155/2020/7613569.
  • 29 Kuroda Y, Young M, Shoman H. et al. Advanced rehabilitation technology in orthopaedics – a narrative review. Int Orthop 2021; 45: 1933-1940 DOI: 10.1007/s00264-020-04814-4.
  • 30 Agency for Clinical Innovation. Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW. Im Internet: https://bit.ly/3W7jKVD; Stand: 12.03.2024
  • 31 Porciuncula F, Roto AV, Kumar D. et al. Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances. PM R 2018; 10: 220-232 DOI: 10.1016/j.pmrj.2018.06.013.
  • 32 Hernandez N, Castro L, Medina-Quero J. et al. Scoping Review of Healthcare Literature on Mobile, Wearable, and Textile Sensing Technology for Continuous Monitoring. J Healthc Inform Res 2021; 5: 270-299 DOI: 10.1007/s41666-020-00087-z.
  • 33 Siciliano BK, Khatib O. eds. Springer Handbook of Robotics. 2nd ed. Springer; 2016. DOI: 10.1007/978-3-319-32552-1
  • 34 Cai L, Liu Y, Wei Z. et al. Robot-assisted rehabilitation training improves knee function and daily activity ability in older adults following total knee arthroplasty. Res Nurs Health 2023; 46: 203-209 DOI: 10.1002/nur.22290.
  • 35 Cha Y, Yoon H, Park C. et al. Untacted automated robotic upper-trunk- lower reciprocal locomotor training for knee osteoarthritis: A randomized controlled trial. BMR 2023; 36: 1101-1110 DOI: 10.3233/BMR-220182.
  • 36 Maeda T, Sasaki E, Kasai T. et al. Therapeutic effect of knee extension exercise with single-joint hybrid assistive limb following total knee arthroplasty: a prospective, randomized controlled trial. Sci Rep 2024; 14: 3889 DOI: 10.1038/s41598-024-53891-7.
  • 37 Payedimarri AB, Ratti M, Rescinito R. et al. Effectiveness of Platform-Based Robot-Assisted Rehabilitation for Musculoskeletal or Neurologic Injuries: A Systematic Review. Bioengineering (Basel) 2022; 9: 129 DOI: 10.3390/bioengineering9040129.
  • 38 Pedersini P, Valdes K, Cantero-Tellez R. et al. Effects of Neurodynamic Mobilizations on Pain Hypersensitivity in Patients With Hand Osteoarthritis Compared to Robotic Assisted Mobilization: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2021; 73: 232-239 DOI: 10.1002/acr.24103.
  • 39 Sardi L, Idri A, Fernández-Alemán JL. A systematic review of gamification in e-Health. J Biomed Inform 2017; 71: 31-48 DOI: 10.1016/j.jbi.2017.05.011.
  • 40 Alfieri FM, Da Silva Dias C, De Oliveira NC. et al. Gamification in Musculoskeletal Rehabilitation. Curr Rev Musculoskelet Med 2022; 15: 629-636 DOI: 10.1007/s12178-022-09797-w.
  • 41 Steiner B, Elgert L, Saalfeld B. et al. Gamification in Rehabilitation of Patients With Musculoskeletal Diseases of the Shoulder: Scoping Review. JMIR Serious Games 2020; 8: e19914 DOI: 10.2196/19914.
  • 42 Gulsen C, Soke F, Eldemir K. et al. Effect of fully immersive virtual reality treatment combined with exercise in fibromyalgia patients: a randomized controlled trial. Assist Technol 2022; 34: 256-263 DOI: 10.1080/10400435.2020.1772900.
  • 43 Özlü A, Ünver G, Tuna Hİ. et al. The Effect of a Virtual Reality-Mediated Gamified Rehabilitation Program on Pain, Disability, Function, and Balance in Knee Osteoarthritis: A Prospective Randomized Controlled Study. Games Health J 2023; 12: 118-124 DOI: 10.1089/g4h.2022.0130.
  • 44 European Commission’s High-Level Expert Group on Artificial Intelligence. A Definition of AI: MAIN CAPABILITIES AND SCIENTIFIC DISCIPLINES. Im Internet: https://bit.ly/3zBUfTy; Stand: 12.03.2024
  • 45 IBM Cloud Education. Machine Learning. Im Internet: https://ibm.co/3XNKhIQ; Stand: 12.03.2024
  • 46 Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen. Digitalisierung für Gesundheit. Ziele und Rahmenbedingungen eines dynamisch lernenden Gesundheitssystems. Im Internet: https://bit.ly/45SV86q; Stand: 12.03.2024
  • 47 Abdollahi M, Ashouri S, Abedi M. et al. Using a Motion Sensor to Categorize Nonspecific Low Back Pain Patients: A Machine Learning Approach. Sensors (Basel) 2020; 20: 3600 DOI: 10.3390/s20123600.
  • 48 Altilio R, Rossetti A, Fang Q. et al. A comparison of machine learning classifiers for smartphone-based gait analysis. Med Biol Eng Comput 2021; 59: 535-546 DOI: 10.1007/s11517-020-02295-6.
  • 49 Bundesminesterium für Gesundheit (BMG). Elektronisches Rezept (E-Rezept). Im Internet: https://bit.ly/3L94zFe; Stand: 12.03.2024
  • 50 Rettinger L, Klupper C, Werner F. et al. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare 2023; 29: 406-414 DOI: 10.1177/1357633x20986038.
  • 51 G.K.V. Spitzenverband. Videosprechstunde, -betreuung/ telemedizinische Leistung per Video. Im Internet: https://bit.ly/3XNKA6s; Stand: 25.01.2024
  • 52 Spitzenverband Bund der Krankenkassen, Bundesverband selbstständiger Physiotherapeuten, Deutschen Verband für Physiotherapeuten et al. Vertrag nach § 125 Absatz 1 SGB V über die Versorgung mit Leistungen der Physiotherapie und deren Vergütung. Im Internet: https://bit.ly/4btP6ui; Stand: 12.03.2024
  • 53 Spitzenverband Bund der Krankenkassen, Bundesverband selbstständiger Physiotherapeuten, Deutschen Verband für Physiotherapeuten et al. Anlage 2; Vergütungsvereinbarung zum Vertrag nach § 125 Absatz 1 SGB V für Physiotherapie. Im Internet: https://bit.ly/45T5ymn; Stand: 12.03.2024
  • 54 GKV Spitzenverband. Liste der Videodienstanbieter. Im Internet: https://bit.ly/4crrVlA; Stand: 03.04.2024
  • 55 Bundesministerium für Gesundheit (BMG). Ärzte sollen Apps verschreiben können. Im Internet: https://bit.ly/3RSTXhq; Stand: 12.03.2024