Implementation of an iteratively developed stoke specific rehabilitation system; perceptions from clinicians and the health service

Background; The implementation of new technologies to provide therapy services requires a change in practice by clinicians. The engagement of clinicians is key to this success, with limited evidence established in the implementation of new technologies (including ‘exergames’ for stroke rehabilitation).

Aim; The aim of this study was to identify clinician engagement in the iterative development of stroke specific software using commercially available Kinect for windows software.

Method; Data was collected from inpatient and outpatient clinicians and those visiting clients at home using multiple methods including individual and group interviews and via email. Therapy disciplines of physiotherapy, occupational therapy and speech pathology were included.

Results; Thematic analysis identified 3 key areas of interactions; between the clinicians and the developers, clinicians and researchers and clinicians and clients.

Discussion; Clinicians valued the opportunity to give feedback to developers and have changes implemented within a 2 week time-frame. Examples of changes include the development of new games (physiotherapists and occupational therapists), changes in images and visual and auditory cues and instructions for games (speech pathologists). Conversely these constant changes provided challenges to staff training and IT support from the health service. Clinicians identified that client motivation, engagement and sustained activities were promoted using the technology solution. The ability to adjust the programs and monitor performance in clinic and remotely, as well as have detailed records of active time in therapy automatically generated were also positive parts of using this technology. Physiotherapists delivering the program in home identified that clients benefited from 2 different programs; a challenging one with therapy assistance and a safer option (focussing on seated upper limb repetitions) for independent practice.

Conclusion; there are challenges in terms of implementing new technologies in clinical practice, but benefits to client engagement and accuracy of activity data collection outweigh these.