A day in the life: a qualitative study of clinical decision‑making and uptake of neurorehabilitation technology

J NeuroEngineering Rehabil, 2021 · DOI: https://doi.org/10.1186/s12984-021-00911-6 · Published: July 15, 2021

Simple Explanation

This study explores how therapists decide whether or not to use rehabilitation technology (RT) during treatment sessions. By having therapists write about their decision-making processes, the researchers identified key factors influencing the adoption of RT in clinical practice. The study found that therapists often perceive RT as less advantageous than traditional methods because it doesn't always align with functional training goals. Patient characteristics, therapist knowledge, device complexity, and organizational support also play significant roles in RT uptake. Ultimately, the research suggests that to improve the integration of RT in rehabilitation, developers need to focus on creating devices that are adaptable, easy to use, relevant to functional activities, and supported by adequate training and organizational resources.

Study Duration

Not specified

Participants

Three OTs and two PTs, nine patients (4 with stroke, 2 traumatic brain injury, 1 spinal cord injury, 1 with multiple sclerosis)

Evidence Level

Qualitative study

Key Findings

1
The most prominent factors influencing RT use are relative advantage, patient attributes, clinician knowledge/beliefs, device complexity, and organizational readiness.
2
Therapists often see RT as having a relative disadvantage compared to conventional treatment due to a lack of relevance to functional training.
3
Clinician comfort with RT is increased by previous training but decreased by the perceived complexity of the technology.

Research Summary

This qualitative study investigated the decision-making processes of OTs and PTs regarding the use of rehabilitation technology (RT) in clinical practice. The study used a phenomenological approach, analyzing vignettes written by therapists to understand the barriers and facilitators of RT implementation. The findings revealed that factors such as the perceived relative advantage of RT, patient attributes, clinician knowledge and beliefs, device complexity, and organizational readiness significantly influence the uptake of RT in inpatient neurologic rehabilitation. The study concludes that to improve RT adoption, developers need to focus on creating devices that are adaptable, user-friendly, functionally relevant, and supported by comprehensive training and organizational support.

Practical Implications

Improve RT Design

RT developers should prioritize creating devices that directly address functional outcomes and are adaptable to a wide range of patient needs and abilities.

Enhance Clinician Training

Implement more comprehensive and ongoing training programs to improve clinician knowledge, comfort, and self-efficacy with RT.

Foster Supportive Environments

Healthcare organizations should invest in creating supportive environments that encourage RT use through adequate resources, time for practice, and organizational incentives.

Study Limitations

1
The study was conducted at a single inpatient rehabilitation hospital, limiting generalizability.
2
The study focused solely on the clinician perspective, neglecting patient and administrative viewpoints.
3
The vignette prompt may have influenced the emphasis on certain topics, such as set-up time.

Your Feedback

Was this summary helpful?

Back to Rehabilitation