Understanding the usability of digital technologies in home-based neurorehabilitation: a realist review
Nay El Hajj, Dahlia Kairy, Quan Nha Hong, Fatima Zeyour, Claude Vincent, Aliki Thomas, Sara Ahmed, Nathalie Bier, Claudine Auger
Full text PDF 
( Download count: 5)
AbstractIntroduction: Digital technologies have the potential to transform home-based neurorehabilitation by improving access to care and enabling intensive therapy. However, the noticeable decrease in adherence to technologies when comparing clinical to home settings suggests critical usability challenges in terms of effectiveness, efficiency, and satisfaction that are not yet fully understood.
Objective: Understand how, why, and under what circumstances are digital technologies usable for home-based neurorehabilitation.
Methods: Following Pawson et al. (2005) methodology and RAMESES I standards, a five stage realist review was conducted: (1) developing an initial theory from existing theoretical frameworks; (2) systematically searching the literature from 2015 to 2023; (3) selecting the studies; (4) extracting Context-Mechanism-Outcome (CMO) configurations; and (5) conducting theory-driven analysis to revise, validate, or eliminate elements from the initial theory leading to a refined middle-range theory.
Results: Of 4,708 records, 134 articles were retained. A total of 379 extracted CMOs were analyzed to refine the initial theory into 9 key mechanisms that can be activated or inhibited by 33 contextual factors, influencing home usability for people with neurological conditions, their caregivers, and health professionals.
Conclusion: The proposed middle-range theory enhances our understanding of digital technology usability and translates theory into practice to guide home neurorehabilitation solutions.Keywords: Digital technology, neurological rehabilitation, home environment, review
Nay El Hajj, Dahlia Kairy, Quan Nha Hong, Fatima Zeyour, Claude Vincent, Aliki Thomas, Sara Ahmed, Nathalie Bier, Claudine Auger (2026). Understanding the usability of digital technologies in home-based neurorehabilitation: a realist review. Gerontechnology, 25(4), 1-16
https://doi.org/10.4017/gt.2026.25.4.1683.7