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BMC Health Services Research

, 16:557

Organization, structure and delivery of healthcare

Abstract

BackgroundDespite increasing evidence for the effectiveness of virtual reality VR-based therapy in stroke rehabilitation, few knowledge translation KT resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills.

MethodsA multi-faceted KT intervention was designed and implemented to support physical and occupational therapists in two stroke rehabilitation units in acquiring proficiency with use of the Interactive Exercise Rehabilitation System IREX; GestureTek. The KT intervention consisted of interactive e-learning modules, hands-on workshops and experiential practice. Evaluation included the Assessing Determinants of Prospective Take Up of Virtual Reality ADOPT-VR Instrument and self-report confidence ratings of knowledge and skills pre- and post-study. Usability of the IREX was measured with the System Usability Scale SUS. A focus group gathered therapist experiences. Frequency of IREX use was recorded for 6 months post-study.

ResultsEleven therapists delivered a total of 107 sessions of VR-based therapy to 34 clients with stroke. On the ADOPT-VR, significant pre-post improvements in therapist perceived behavioral control p = 0.003, self-efficacy p = 0.005 and facilitating conditions p =0.019 related to VR use were observed. Therapist intention to use VR did not change. Knowledge and skills improved significantly following e-learning completion p = 0.001 and was sustained 6 months post-study. Below average perceived usability of the IREX 19 percentile was reported. Lack of time was the most frequently reported barrier to VR use. A decrease in frequency of perceived barriers to VR use was not significant p = 0.159. Two therapists used the IREX sparingly in the 6 months following the study. Therapists reported that client motivation to engage with VR facilitated IREX use in practice but that environmental and IREX-specific barriers limited use.

ConclusionsDespite increased knowledge and skills in VR use, the KT intervention did not alter the number of perceived barriers to VR use, intention to use or actual use of VR. Poor perceived system usability had an impact on integration of this particular VR system into clinical practice.

KeywordsKnowledge translation Virtual reality Rehabilitation Stroke Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1807-6 contains supplementary material, which is available to authorized users.

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Autor: Danielle Levac - Stephanie M. N. Glegg - Heidi Sveistrup - Heather Colquhoun - Patricia A. Miller - Hillel Finestone - Vi

Fuente: https://link.springer.com/







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