Adoption of Stroke Rehabilitation Technologies by the User Community: Qualitative Study

Andrew Kerr, Mark Smith, Lynn Reid, Lynne Baillie, Andrew Kerr, Mark Smith, Lynn Reid, Lynne Baillie

Abstract

Background: Using technology in stroke rehabilitation is attractive. Devices such as robots or smartphones can help deliver evidence-based levels of practice intensity and automated feedback without additional labor costs. Currently, however, few technologies have been adopted into everyday rehabilitation.

Objective: This project aimed to identify stakeholder (therapists, patients, and caregivers) priorities for stroke rehabilitation technologies and to generate user-centered solutions for enhancing everyday adoption.

Methods: We invited stakeholders (n=60), comprising stroke survivors (20/60, 33%), therapists (20/60, 33%), caregivers, and technology developers (including researchers; 20/60, 33%), to attend 2 facilitated workshops. Workshop 1 was preceded by a national survey of stroke survivors and therapists (n=177) to generate an initial list of priorities. The subsequent workshop focused on identifying practical solutions to enhance adoption.

Results: A total of 25 priorities were generated from the survey; these were reduced to 10 nonranked priorities through discussion, consensus activities, and voting at Workshop 1: access to technologies, ease of use, awareness of available technologies, technologies focused on function, supports self-management, user training, evidence of effectiveness, value for money, knowledgeable staff, and performance feedback. The second workshop provided recommendations for improving the adoption of technologies in stroke rehabilitation: an annual exhibition of commercially available and developing technologies, an online consumer-rating website of available technologies, and a user network to inspire and test new technologies.

Conclusions: The key outcomes from this series of stakeholder workshops provides a starting point for an integrated approach to promoting greater adoption of technologies in stroke rehabilitation. Bringing technology developers and users together to shape future and evaluate current technologies is critical to achieving evidence-based stroke rehabilitation.

Keywords: priorities; rehabilitation; stroke; technology.

©Andrew Kerr, Mark Smith, Lynn Reid, Lynne Baillie. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 17.08.2018.

Figures

Figure 1
Figure 1
Top ten priority circle.

References

    1. NHS Scotland ISD. [2018-04-26]. Scottish Stroke Statistics .
    1. Stroke Association. [2018-03-05]. State of the Nation: stroke statistics 2015 .
    1. WHO. 2004. [2018-04-26]. The Atlas of Heart Disease and Stroke .
    1. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009 Aug;8(8):741–54. doi: 10.1016/S1474-4422(09)70150-4.S1474-4422(09)70150-4
    1. French B, Thomas LH, Coupe Jacqueline, McMahon Naoimh E, Connell Louise, Harrison Joanna, Sutton Christopher J, Tishkovskaya Svetlana, Watkins Caroline L. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev. 2016 Dec 14;11:CD006073. doi: 10.1002/14651858.CD006073.pub3.
    1. Mehrholz J, Hädrich Anja, Platz T, Kugler J, Pohl M. Electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2012 Jun 13;(6):CD006876. doi: 10.1002/14651858.CD006876.pub3.
    1. Mehrholz Jan, Elsner B, Pohl M. Treadmill Training for Improving Walking Function After Stroke: A Major Update of a Cochrane Review. Stroke. 2014 Feb 20;45(5):e76–e77. doi: 10.1161/STROKEAHA.114.004999.CIR.0000000000000219
    1. Cooke E, Mares K, Clark A, Tallis R, Pomeroy Valerie M. The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: a systematic review and meta-analysis. BMC Med. 2010 Oct 13;8:60. doi: 10.1186/1741-7015-8-60. 1741-7015-8-60
    1. Stein J. Robotics in rehabilitation: technology as destiny. Am J Phys Med Rehabil. 2012 Nov;91(11 Suppl 3):S199–203. doi: 10.1097/PHM.0b013e31826bcbbd.00002060-201211003-00001
    1. NHS Scotland Quality Strategy - putting people at the heart of our NHS. Edinburgh, Scotland: The Scottish Government; 2010. .
    1. Scottish Govenment 2014. [2018-08-03]. Stroke Improvement Plan .
    1. Pollock A, St GB, Fenton M, Firkins L. Top ten research priorities relating to life after stroke. Lancet Neurol. 2012 Mar;11(3):209. doi: 10.1016/S1474-4422(12)70029-7.S1474-4422(12)70029-7
    1. Burridge JH, Hughes A. Potential for new technologies in clinical practice. Curr Opin Neurol. 2010 Dec;23(6):671–7. doi: 10.1097/WCO.0b013e3283402af5.
    1. Demain S, Burridge J, Ellis-Hill C, Hughes A, Yardley L, Tedesco-Triccas L, Swain I. Assistive technologies after stroke: self-management or fending for yourself? A focus group study. BMC Health Serv Res. 2013 Aug 22;13:334. doi: 10.1186/1472-6963-13-334. 1472-6963-13-334
    1. Partridge N, Scadding J. The James Lind Alliance: patients and clinicians should jointly identify their priorities for clinical trials. Lancet. 2004;364(9449):1923–4. doi: 10.1016/S0140-6736(04)17494-1.S0140673604174941
    1. Scherer M. Technology adoption, acceptance, satisfaction and benefit: integrating various assistive technology outcomes. Disabil Rehabil Assist Technol. 2017 Dec;12(1):1–2. doi: 10.1080/17483107.2016.1253939.
    1. Hughes A, Burridge JH, Demain SH, Ellis-Hill C, Meagher C, Tedesco-Triccas L, Turk R, Swain I. Translation of evidence-based Assistive Technologies into stroke rehabilitation: users' perceptions of the barriers and opportunities. BMC Health Serv Res. 2014 Mar 12;14:124. doi: 10.1186/1472-6963-14-124. 1472-6963-14-124
    1. Cumberland Consensus Working Group. Cheeran Binith, Cohen Leonardo, Dobkin Bruce, Ford Gary, Greenwood Richard, Howard David, Husain Masud, Macleod Malcolm, Nudo Randolph, Rothwell John, Rudd Anthony, Teo James, Ward Nicholas, Wolf Steven. The future of restorative neurosciences in stroke: driving the translational research pipeline from basic science to rehabilitation of people after stroke. Neurorehabil Neural Repair. 2009 Feb;23(2):97–107. doi: 10.1177/1545968308326636. 23/2/97
    1. Lam MY, Tatla SK, Lohse KR, Shirzad N, Hoens AM, Miller KJ, Holsti L, Virji-Babul N, Van DLHFM. Perceptions of Technology and Its Use for Therapeutic Application for Individuals With Hemiparesis: Findings From Adult and Pediatric Focus Groups. JMIR Rehabil Assist Technol. 2015 Feb 10;2(1):e1. doi: 10.2196/rehab.3484. v2i1e1

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