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

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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.

Related collections

Most cited references 54

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Internet-Based Physical Activity Interventions: A Systematic Review of the Literature

Marleen van den Berg, Johannes W Schoones, Theodora Vliet Vlieland (2007)

Background Nowadays people are extensively encouraged to become more physically active. The Internet has been brought forward as an effective tool to change physical activity behavior. However, little is known about the evidence regarding such Internet-based interventions. Objective The aim of the study was to systematically assess the methodological quality and the effectiveness of interventions designed to promote physical activity by means of the Internet as evaluated by randomized controlled trials. Methods A literature search was conducted up to July 2006 using the databases PubMed, Web of Science, EMBASE, PsycINFO, and Cochrane Library. Only randomized controlled trials describing the effectiveness of an Internet-based intervention, with the promotion of physical activity among adults being one of its major goals, were included. Data extracted included source and year of publication, country of origin, targeted health behaviors, participants’ characteristics, characteristics of the intervention, and effectiveness data. In addition, the methodological quality was assessed. Results The literature search resulted in 10 eligible studies of which five met at least nine out of 13 general methodological criteria. The majority of the interventions were tailored to the characteristics of the participants and used interactive self-monitoring and feedback tools. Six studies used one or more theoretical models to compose the contents of the interventions. One study used an objective measure to assess the amount of physical activity (activity monitor), and six studies used multiple subjective measures of physical activity. Furthermore, half of the studies employed measures of physical fitness other than physical activity. In three studies, an Internet-based physical activity intervention was compared with a waiting list group. Of these three studies, two reported a significantly greater improvement in physical activity levels in the Internet-based intervention than in the control group. Seven studies compared two types of Internet-based physical activity interventions in which the main difference was either the intensity of contact between the participants and supervisors (4 studies) or the type of treatment procedures applied (3 studies). In one of these studies, a significant effect in favor of an intervention with more supervisor contact was seen. Conclusions There is indicative evidence that Internet-based physical activity interventions are more effective than a waiting list strategy. The added value of specific components of Internet-based physical activity interventions such as increased supervisor contact, tailored information, or theoretical fidelity remains to be established. Methodological quality as well as the type of physical activity outcome measure varied, stressing the need for standardization of these measures.

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Establishing the computer-patient working alliance in automated health behavior change interventions.

Rosalind Picard, Amanda Gruber, Timothy W Bickmore (2005)

Current user interfaces for automated patient and consumer health care systems can be improved by leveraging the results of several decades of research into effective patient-provider communication skills. A research project is presented in which several such "relational" skills - including empathy, social dialogue, nonverbal immediacy behaviors, and other behaviors to build and maintain good working relationships over multiple interactions - are explicitly designed into a computer interface within the context of a longitudinal health behavior change intervention for physical activity adoption. Results of a comparison among 33 subjects interacting near-daily with the relational system and 27 interacting near-daily with an identical system with the relational behaviors ablated, each for 30 days indicate, that the use of relational behaviors by the system significantly increases working alliance and desire to continue working with the system. Comparison of the above groups to another group of 31 subjects interacting with a control system near-daily for 30 days also indicated a significant increase in proactive viewing of health information.

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A randomized controlled trial of an automated exercise coach for older adults.

Timothy W Bickmore, Rebecca A. Silliman, Kerrie Nelson … (2013)

To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults.

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Author and article information

Contributors

Peppino Tropea:

ORCID: http://orcid.org/0000-0001-8238-9619

Department of Neurorehabilitation SciencesCasa Cura Policlinicovia Giuseppe Dezza, 48Milano, 20144Italy39 024859 ext 312439 0248593312p.tropea@ccppdezza.it

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: September 2019

Publication date (Electronic): 1 October 2019

Volume: 21

Issue: 10

Electronic Location Identifier: e12805

Affiliations

[1 ] Department of Neurorehabilitation Sciences Casa Cura Policlinico Milano Italy

[2 ] Chair of Wirtschaftsinformatik, esp. Systems Development Faculty of Business and Economics Technische Universität Dresden Dresden Germany

[3 ] Neurology Department, Neurodegenerative Diseases Group Biocruces Bizkaia Health Research Institute Hospital Universitario Cruces Barakaldo, Bizkaia Spain

[4 ] Ikerbasque: The Basque Foundation for Science Bilbao Spain

[5 ] Universitatea de Medicina si Farmacie “Carol Davila” Bucuresti Romania

[6 ] Department of Business Development and Technology Aarhus University Aarhus Denmark

Author notes

Corresponding Author: Peppino Tropea p.tropea@ 123456ccppdezza.it

Author information

Peppino Tropea http://orcid.org/0000-0001-8238-9619

Hannes Schlieter http://orcid.org/0000-0002-6513-9017

Irma Sterpi http://orcid.org/0000-0003-0035-8881

Elda Judica http://orcid.org/0000-0002-1965-304X

Kai Gand http://orcid.org/0000-0003-2065-8523

Massimo Caprino http://orcid.org/0000-0002-6966-6770

Inigo Gabilondo http://orcid.org/0000-0001-6045-2840

Juan Carlos Gomez-Esteban http://orcid.org/0000-0002-4697-3890

Stefan Busnatu http://orcid.org/0000-0002-4678-9655

Crina Sinescu http://orcid.org/0000-0001-5933-8549

Sofoklis Kyriazakos http://orcid.org/0000-0002-8841-6558

Sadia Anwar http://orcid.org/0000-0003-4179-230X

Massimo Corbo http://orcid.org/0000-0003-0793-9830

Article

Publisher ID: v21i10e12805

DOI: 10.2196/12805

PMC ID: 6774233

PubMed ID: 31573902

SO-VID: d0c60310-646d-4e91-a917-dd3b6391152c

Copyright © ©Peppino Tropea, Hannes Schlieter, Irma Sterpi, Elda Judica, Kai Gand, Massimo Caprino, Inigo Gabilondo, Juan Carlos Gomez-Esteban, Stefan Busnatu, Crina Sinescu, Sofoklis Kyriazakos, Sadia Anwar, Massimo Corbo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.10.2019

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 21 November 2018

Date revision requested : 31 March 2019

Date revision received : 25 July 2019

Date accepted : 27 July 2019

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