Fizyoterapide Dijitalleşme
Özet
Son yıllarda sağlık alanında dijitalleşme süreci hız kazanmış, Covid-19 pandemisiyle birlikte bu süreç belirgin şekilde ivme göstermiştir. Dijital sağlık teknolojileri; hasta ve klinisyenlere erişilebilirlik, maliyet etkinliği, veri yönetimi ve klinik karar destek süreçlerinde önemli avantajlar sunmaktadır. Bu gelişmeler, fizyoterapi ve rehabilitasyon uygulamalarında da dijital araçların kullanımını yaygınlaştırmıştır. Bu bölümde, fizyoterapide kullanılan sık dijital sağlık yaklaşımları ele alınmaktadır. Sanal gerçeklik (virtual reality, VR) ve artırılmış gerçeklik (augmented reality, AR) uygulamaları, motivasyonel ve duyusal geri bildirimlerle desteklenen tekrarlayıcı egzersizler aracılığıyla motor öğrenmeyi ve nöroplastisiteyi desteklemektedir. İnme, parkinson, multipl skleroz (MS), serebral palsi ve kas-iskelet sistemi bozukluklarında fonksiyonel iyileşme, ağrı kontrolü, bağımsızlık ve yaşam kalitesine olumlu etkileri gösterilmiştir. Tele-rehabilitasyon ise özellikle pandemi döneminde öne çıkmış; sesli, görüntülü, sensör tabanlı ve VR destekli yöntemlerle hastaların ev ortamında güvenli ve sürdürülebilir bir şekilde tedaviye erişimini sağlamıştır. Sonuç olarak, dijital sağlık teknolojileri fizyoterapi uygulamalarında etkili, erişilebilir ve yenilikçi bir yaklaşım sunmaktadır. Bununla birlikte, egzersiz türü, dozajı ve yöntemlerin standardizasyonu konularında daha fazla bilimsel çalışmaya ihtiyaç vardır.
Referanslar
Baeza-Barragán, M. R., Manzanares, M. T. L., Vergara, C. R., Casuso-Holgado, M. J., & Martín-Valero, R. (2020). The use of virtual reality technologies in the treatment of Duchenne muscular dystrophy: systematic review. JMIR MHealth and UHealth, 8(12), e21576.
Baudier, P., Kondrateva, G., Ammi, C., Chang, V., & Schiavone, F. (2023). Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs. Technovation, 120, 102547.
Biçki, D., & Düz, A. N. Y. (2025). The Role and Impact of Digital Health Literacy in Physical Therapy and Rehabilitation. Sanitas Magisterium, 11(2), 1–7.
Bose, S., Dun, C., Zhang, G. Q., Walsh, C., Makary, M. A., & Hicks, C. W. (2022). Medicare Beneficiaries In Disadvantaged Neighborhoods Increased Telemedicine Use During The COVID-19 Pandemic: Study examines use of telemedicine by Medicare beneficiaries in disadvantaged neighborhoods during the COVID-19 pandemic. Health Affairs, 41(5), 635–642.
Brepohl, P. C. A., & Leite, H. (2023a). Virtual reality applied to physiotherapy: a review of current knowledge. Virtual Reality, 27(1), 71–95.
Brepohl, P. C. A., & Leite, H. (2023b). Virtual reality applied to physiotherapy: a review of current knowledge. Virtual Reality, 27(1), 71–95.
Chen, J., Or, C. K., & Chen, T. (2022). Effectiveness of using virtual reality–supported exercise therapy for upper extremity motor rehabilitation in patients with stroke: systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research, 24(6), e24111.
Corbetta, D., Imeri, F., & Gatti, R. (2015). Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review. Journal of Physiotherapy, 61(3), 117–124.
Cortes-Perez, I., Sanchez-Alcala, M., Nieto-Escámez, F. A., Castellote-Caballero, Y., Obrero-Gaitan, E., & Osuna-Pérez, M. C. (2021). Virtual reality-based therapy improves fatigue, impact, and quality of life in patients with multiple sclerosis. A systematic review with a meta-analysis. Sensors, 21(21), 7389.
Cox, N. S., Dal Corso, S., Hansen, H., McDonald, C. F., Hill, C. J., Zanaboni, P., Alison, J. A., O’Halloran, P., Macdonald, H., & Holland, A. E. (2021). Telerehabilitation for chronic respiratory disease. Cochrane Database of Systematic Reviews, 1.
Dockx, K., Bekkers, E. M. J., Van den Bergh, V., Ginis, P., Rochester, L., Hausdorff, J. M., Mirelman, A., & Nieuwboer, A. (2016). Virtual reality for rehabilitation in Parkinson’s disease. Cochrane Database of Systematic Reviews, 12.
Farshid, M., Paschen, J., Eriksson, T., & Kietzmann, J. (2018). Go boldly!: Explore augmented reality (AR), virtual reality (VR), and mixed reality (MR) for business. Business Horizons, 61(5), 657–663.
Freeman, D., Reeve, S., Robinson, A., Ehlers, A., Clark, D., Spanlang, B., & Slater, M. (2017). Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological Medicine, 47(14), 2393–2400.
Gil, M. J. V., Gonzalez-Medina, G., Lucena-Anton, D., Perez-Cabezas, V., Ruiz-Molinero, M. D. C., & Martín-Valero, R. (2021a). Augmented reality in physical therapy: systematic review and meta-analysis. JMIR Serious Games, 9(4), e30985.
Gil, M. J. V., Gonzalez-Medina, G., Lucena-Anton, D., Perez-Cabezas, V., Ruiz-Molinero, M. D. C., & Martín-Valero, R. (2021b). Augmented reality in physical therapy: systematic review and meta-analysis. JMIR Serious Games, 9(4), e30985.
Goudman, L., Jansen, J., Billot, M., Vets, N., De Smedt, A., Roulaud, M., Rigoard, P., & Moens, M. (2022). Virtual reality applications in chronic pain management: systematic review and meta-analysis. JMIR Serious Games, 10(2), e34402.
Gumaa, M., & Rehan Youssef, A. (2019). Is virtual reality effective in orthopedic rehabilitation? A systematic review and meta-analysis. Physical Therapy, 99(10), 1304–1325.
Holland, A. E. (2017). Telephysiotherapy: time to get online. Journal of Physiotherapy, 63(4), 193–195.
Horton, E. J., Mitchell, K. E., Johnson-Warrington, V., Apps, L. D., Sewell, L., Morgan, M., Taylor, R. S., & Singh, S. J. (2018). Comparison of a structured home-based rehabilitation programme with conventional supervised pulmonary rehabilitation: a randomised non-inferiority trial. Thorax, 73(1), 29–36.
Kairy, D., Lehoux, P., Vincent, C., & Visintin, M. (2009). A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disability and Rehabilitation, 31(6), 427–447.
Kalyon, T. A. (1999). Telerehabilitasyon. Fiziksel Tıp, 2(2), 53–58. https://www.jpmrs.org/uploads/pdf_PMJ_200.pdf
Kiper, P., Godart, N., Cavalier, M., Berard, C., Cieślik, B., Federico, S., Kiper, A., Pellicciari, L., & Meroni, R. (2023a). Effects of immersive virtual reality on upper-extremity stroke rehabilitation: a systematic review with meta-analysis. Journal of Clinical Medicine, 13(1), 146.
Kiper, P., Godart, N., Cavalier, M., Berard, C., Cieślik, B., Federico, S., Kiper, A., Pellicciari, L., & Meroni, R. (2023b). Effects of immersive virtual reality on upper-extremity stroke rehabilitation: a systematic review with meta-analysis. Journal of Clinical Medicine, 13(1), 146.
Krohn, M., Rintala, A., Immonen, J., & Sjögren, T. (2024). The effectiveness of therapeutic exercise interventions with virtual reality on balance and walking among persons with chronic stroke: systematic review, meta-analysis, and meta-regression of randomized controlled trials. Journal of Medical Internet Research, 26, e59136.
Lang, S., McLelland, C., MacDonald, D., & Hamilton, D. F. (2022). Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials. Archives of Physiotherapy, 12(1), 24.
Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2018). Virtual reality for stroke rehabilitation. Stroke, 49(4), e160–e161.
Levin, M. F., Weiss, P. L., & Keshner, E. A. (2015). Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles. Physical Therapy, 95(3), 415–425.
Lo, H. H. M., Zhu, M., Zou, Z., Wong, C. L., Lo, S. H. S., Chung, V. C.-H., Wong, S. Y.-S., & Sit, R. W. S. (2024). Immersive and Nonimmersive Virtual Reality–Assisted Active Training in Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 26, e48787.
Lucena-Anton, D., Fernandez-Lopez, J. C., Pacheco-Serrano, A. I., Garcia-Munoz, C., & Moral-Munoz, J. A. (2022). Virtual and augmented reality versus traditional methods for teaching physiotherapy: a systematic review. European Journal of Investigation in Health, Psychology and Education, 12(12), 1780–1792.
Muñoz-Tomás, M. T., Burillo-Lafuente, M., Vicente-Parra, A., Sanz-Rubio, M. C., Suarez-Serrano, C., Marcén-Román, Y., & Franco-Sierra, M. Á. (2023). Telerehabilitation as a therapeutic exercise tool versus face-to-face physiotherapy: a systematic review. International Journal of Environmental Research and Public Health, 20(5), 4358.
Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., Rivera, D. E., West, R., & Wyatt, J. C. (2016a). Evaluating digital health interventions: key questions and approaches. In American journal of preventive medicine (Vol. 51, Issue 5, pp. 843–851). Elsevier.
Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., Rivera, D. E., West, R., & Wyatt, J. C. (2016b). Evaluating digital health interventions: key questions and approaches. In American journal of preventive medicine (Vol. 51, Issue 5, pp. 843–851). Elsevier.
Physiotherapy, W. (2019a). Report of the World Physiotherapy/INPTRA digital physical therapy practice task force. UK: World Physiotherapy London.
Physiotherapy, W. (2019b). Report of The World Physiotherapy/Inptra Dıgıtal Physical Therapy Practice Task Force. World Confederation for Physical Therapy.
Plavoukou, T., Staktopoulos, P., Papagiannis, G., Stasinopoulos, D., & Georgoudis, G. (2025). Virtual and Augmented Reality for Chronic Musculoskeletal Rehabilitation: A Systematic Review and Exploratory Meta-Analysis. Bioengineering, 12(7), 745.
Popov, V. V, Kudryavtseva, E. V, Kumar Katiyar, N., Shishkin, A., Stepanov, S. I., & Goel, S. (2022). Industry 4.0 and digitalisation in healthcare. Materials, 15(6), 2140.
Rajkumar Krishnan, V., Yughdtheswari, M., & Kaanmalar, A. (2019). Digital physiotherapy intervention in health care delivery–a narrative review. INTI JOURNAL, 2019(26).
Rodríguez-Mansilla, J., Bedmar-Vargas, C., Garrido-Ardila, E. M., Torres-Piles, S. T., González-Sánchez, B., Rodríguez-Domínguez, M. T., Ramírez-Durán, M. V., & Jiménez-Palomares, M. (2023). Effects of virtual reality in the rehabilitation of Parkinson’s disease: a systematic review. Journal of Clinical Medicine, 12(15), 4896.
Ronquillo, Y., Meyers, A., & Korvek, S. J. (2017). Digital health.
Seron, P., Oliveros, M.-J., Gutierrez-Arias, R., Fuentes-Aspe, R., Torres-Castro, R. C., Merino-Osorio, C., Nahuelhual, P., Inostroza, J., Jalil, Y., & Solano, R. (2021). Effectiveness of telerehabilitation in physical therapy: a rapid overview. Physical Therapy, 101(6), pzab053.
Sessoms, P. H., Fraser, J. J., Bodell, D. M., Haluch, K. S., Markham, A. E., Brookfield, J. S., Jameson, J., & Gottshall, K. R. (2023). Clinical effectiveness of virtual reality versus conventional clinic-based vestibular physical therapy on balance and function in active duty service members. A pilot randomized controlled trial. Virtual Reality, 27(1), 263–276.
Simmich, J., Ross, M. H., & Russell, T. (2024). Real-time video telerehabilitation shows comparable satisfaction and similar or better attendance and adherence compared with in-person physiotherapy: a systematic review. Journal of Physiotherapy, S1836-9553.
Suso-Martí, L., La Touche, R., Herranz-Gómez, A., Angulo-Díaz-Parreño, S., Paris-Alemany, A., & Cuenca-Martínez, F. (2021). Effectiveness of telerehabilitation in physical therapist practice: an umbrella and mapping review with meta–meta-analysis. Physical Therapy, 101(5), pzab075.
Theodoros, D., Russell, T., & Latifi, R. (2008a). Telerehabilitation: current perspectives. Studies in Health Technology and Informatics, 131(1), 191–210.
Theodoros, D., Russell, T., & Latifi, R. (2008b). Telerehabilitation: current perspectives. Studies in Health Technology and Informatics, 131(1), 191–210.
Tobaiqi, M. A., Albadawi, E. A., Fadlalmola, H. A., & Albadrani, M. S. (2023). Application of virtual reality-assisted exergaming on the rehabilitation of children with cerebral palsy: a systematic review and meta-analysis. Journal of Clinical Medicine, 12(22), 7091.
Tore, N. G. (2023). Telerehabilitasyon. Gazi Sağlık Bilimleri Dergisi, 7. Ulusal Romatolojik Rehabilitasyon Kongresi Özet Bildiri Özel Sayısı, 7–8.
Tsai, L. L. Y., McNamara, R. J., Moddel, C., Alison, J. A., McKenzie, D. K., & McKeough, Z. J. (2017). Home‐based telerehabilitation via real‐time videoconferencing improves endurance exercise capacity in patients with COPD: the randomized controlled TeleR Study. Respirology, 22(4), 699–707.
Vassantachart, A. Y., Yeo, E., & Chau, B. (2022). Virtual and augmented reality-based treatments for phantom limb pain: a systematic review. Innovations in Clinical Neuroscience, 19(10–12), 48.
Weiss, P. L., Keshner, E. A., Levin, M. F., & Sharkey, P. (2014). Applying virtual reality technologies to motor rehabilitation. Virtual Reality Technologies for Health and Clinical Applications, 1.
Weiss, P. L., Kizony, R., Feintuch, U., & Katz, N. (2006). Virtual reality in neurorehabilitation. Textbook of Neural Repair and Rehabilitation, 51(8), 182–197.
