Relevance: Strokes are the world's leading cause of adult disability, with motor impairment causing disability through inability to perform activities of daily living (ADL). Impairment is much more common in the upper limb (UL), leading to the recommendation for more effective therapies. Technology is forming an increasing part of life, with robotic devices being developed for stroke rehabilitation under the theory of repetition to aid plasticity. Development is proposed to increase a physiotherapist's efficiency through increased repetitions. Robotic therapy (RT) is recommended as an adjunct and within the literature widespread improvements are found in movement, but limited effect on functional capabilities. Effectiveness and acceptability are required for the uptake of technology, but research is lacking in user experience, specifically that of the physiotherapist. Purpose: The current study aims to contribute to the growing body of evidence for RT following a stroke by answering the research question: how do physiotherapists perceive RT for UL rehabilitation following stroke? Methods: Six physiotherapists took part in the study, sharing their views and experiences through semi-structured interviews. Digital recording was used to transcribe each interview; all were member-checked by participants. Analysis: Thematic analysis was used to interpret data by the development of themes and subthemes through coding. An emergent model was created following investigator triangulation. Results: Perceptions of RT by physiotherapists was generally positive, but it was strongly regarded as an adjunct to therapy. Individualised care was placed centrally in the emergent model, due to the fact that physiotherapists were working towards a patient-centred approach. Critical thinking was widely displayed regarding the use of RT. The process of working with the machine was important, as therapeutic relationships ensured individualised care and technical relationships ensured good upkeep of the machine. Efficient use of skill mix within the team was proposed, as it was accepted that a physiotherapy assistant could be utilised to provide RT. Ultimately, resources determined decision-making in regards to RT and were seen as a limiting factor to its acceptability. Conclusions: RT was generally perceived positively by physiotherapists but was strongly regarded as an adjunct to current conventional physiotherapy intervention. A model of physiotherapist's decision-making in relation to robotic therapy was proposed based on emergent findings. Impact and Implications: RT was generally perceived positively by physiotherapists but was strongly regarded as an adjunct. An area for future research of RT includes the production of guidelines towards its use.
|Published - Oct 2015
|Physiotherapy UK 2015 - Liverpool
Duration: 1 Oct 2015 → …
|Physiotherapy UK 2015
|1/10/15 → …