Factors that influence the adoption of rehabilitation technologies: a multi-disciplinary qualitative exploration

Abstract

Background Technological innovation is recognised as having the potential to enhance rehabilitation for people with disability. Yet, resistance to, and abandonment of, rehabilitation technology is prevalent and the successful translation of technology into rehabilitation settings remains limited. Therefore, the aim of this work was to develop an in-depth, multi-stakeholder perspective on what influences the adoption of rehabilitation technologies. Methods Semi-structured focus groups were conducted as part of a larger research project aiming to facilitate the co-design of a novel neurorestorative technology. Focus group data were analysed using a five-phase hybrid deductive-inductive approach to qualitative data analysis. Results Focus groups were attended by 43 stakeholders with expertise in one or more of the following fields: people with disability, allied health, human movement science, computer science, design, engineering, ethics, funding, marketing, business, product development, and research development. Six main themes influencing the adoption of technology in rehabilitation were identified: cost beyond the purchase price, benefits to all stakeholders, trust to be earned in technology, ease of technology operation, ability to access technology, and the ‘co’ in co-design. All six themes were found to be interrelated; in particular, the importance of direct stakeholder engagement in the development of rehabilitation technologies (the ‘co’ in co-design) was prevalent in all themes. Conclusions A range of complex and interrelated factors influence the adoption of rehabilitation technologies. Importantly, many of the issues that have the potential to negatively impact rehabilitation technology adoption may be addressed during development by utilising the experience and expertise of stakeholders who influence its supply and demand. Our findings state that a wider cohort of stakeholders needs to be actively engaged in the development of rehabilitation technologies to better address the factors that contribute to technology underutilisation and abandonment and facilitate better outcomes for people with disability.

Economic Cost of Rehabilitation with Robotic and Virtual Reality Systems in People with Neurological Disorders: A Systematic Review

“…There are many advantages derived from using robots and virtual reality systems in neurorehabilitation. These advantages are mainly related to the increase in intensity, number of repetitions, specificity and feedback during rehabilitation [ 8 ]. These devices, widely present in specialized rehabilitation centres with a high number of patients with neurological disorders, are considered helpful for assessing deficits and hence for assessing rehabilitation outcomes; they are also treatment tools, which are managed by specialized and trained personnel.…”

“…These devices, widely present in specialized rehabilitation centres with a high number of patients with neurological disorders, are considered helpful for assessing deficits and hence for assessing rehabilitation outcomes; they are also treatment tools, which are managed by specialized and trained personnel. However, there are barriers to their adoption [ 8 , 9 ]. Although the scientific literature appears to provide strong support for certain technology-based approaches, their rate of adoption lags far behind the rate that might be expected considering the potential positive consequences associated with their use and the supporting scientific evidence.…”

Uncovering clinical rehabilitation technology trends: field observations, mixed methods analysis, and data visualization

“…Rehabilitation technology (RT) 4 is surprisingly under-used. 5 Despite the significant funding and years of multi-disciplinary efforts from researchers, developers, and clinicians; cutting-edge tools for individual with disabilities--such as virtual reality, 6 robotics, 7 and wearable sensors 8 --rarely see widespread clinical use. The persistent challenge in rehabilitation sciences lies in the disconnect between RT development and clinical use.…”

“…The persistent challenge in rehabilitation sciences lies in the disconnect between RT development and clinical use. 5,8–13 Traditionally, research has focused on efficacy and feasibility studies instead of the factors that influence real-world use of technologies in clinical practice. 13–16 Perhaps developers do not know enough about the end-stage of this adoption process, leaving a gap to explore the success or failure of effective RT in clinical practice.…”

“…To address this gap, we sought to understand the qualities of widely used technologies in clinical treatment, and the factors that facilitate or hinder RT-use. In previous studies, barriers and facilitators of RT into clinical practice have been explored primarily through self-reporting, including surveys, 11,17,18 interviews, 11,17 focus groups, 5 case studies, 14 and vignettes. 19 For example, clinicians provided vignettes describing RT-use decisions during treatment sessions, revealing that new RT is not seen as advantageous due to time and complexity.…”