Observations of technology use in neuro-rehabilitation

Research Objectives: To gain insights into (1) devices used, (2) time spent using devices, (3) and therapists’ behaviors

Design: Mixed methods field observations

Setting: Inpatient, DayRehabilitation, and outpatient therapy areas that includes high-tech device options

Participants: Occupational and physical therapists

Interventions: Observations were completed between January 2000 - September 2022 by three research clinicians (2 PT, 1 OT). 44 hours of observations were completed. Saturation of observation was defined as no new devices observed or being used in a different way.

Main Outcome Measures: (1) Rehabilitation technology (RT) use categorization including power source, therapeutic objective, treatment intervention, advanced technology (e.g., training, precise measurement, electrical stimulation) or conventional RT (e.g., weight machines, mat table); (2) Minutes spent using each device; (3) Deductive coding of therapist behavior, including instructions, feedback, and point of care documentation habits.

Results: 330 RT uses were observed, with the majority used for training (n=238, 72%) rather than measurement (92, 28%), or assistance (n=1, .3%). Advanced RT (n=220, 67%) was used more than conventional RT (n=110, 33%). Among advanced RT, training devices (121,55%) were used more than precise measurement tools (n=84,38%), or electrical stimulation (n=15, 6.8%). Average setup time was 3±4 minutes, and total average time with RT (including setup and breakdown) was 20±16 minutes. Instructions were brief with feedback based on knowledge of performance. Therapist attention was split evenly between documentation (n=166, 50%) and patient engagement (n=165, 50%).

Conclusions: Clinicians favor advanced RT over conventional RT. They prioritize devices that are simpler, quick to set up, and allow them to perform treatment and documentation tasks simultaneously. Future implementation work is needed to help RT crack the adoption barrier.

Author(s) Disclosures: This study was funded by NIDILRR 90REGE0010 and 90REGE0005.