4.7 Article

Determining Factors that Influence Adoption of New Post-Stroke Sensorimotor Rehabilitation Devices in the USA

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/TNSRE.2021.3090571

Keywords

Interviews; Stakeholders; Stroke (medical condition); Medical treatment; National Institutes of Health; Object recognition; Companies; Stroke; stroke rehabilitation; rehabilitation device; occupational therapy; physical therapy; implementation; technology

Funding

  1. National Institutes of Health/National Center for Advancing Translational Services (NIH/NCATS) [TL1 TR001451, UL1 TR001450]
  2. NIH/National Institute of Child Health and Human Development (NICHD) [3R41HD09079201A1S1, 1R01HD094731-01A1]
  3. NIH [R41HD090792-01A1]
  4. NIH/National Institute of General Medicine Sciences (NIGMS) [P20GM109040]

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The role of therapists is crucial in the clinical adoption of rehabilitation devices. Outpatient and inpatient rehabilitation settings are identified as the best environments to introduce restorative devices, with therapists and rehabilitation directors having significant influence on device adoption.
Rehabilitation device efficacy alone does not lead to clinical practice adoption. Previous literature identifies drivers for device adoption by therapists but does not identify the best settings to introduce devices, the roles of different stakeholders including rehabilitation directors, or specific criteria to be met during device development. The objective of this work was to provide insights into these areas to increase clinical adoption of post-stroke restorative rehabilitation devices. We interviewed 107 persons including physical/occupational therapists, rehabilitation directors, and stroke survivors and performed content analysis. Unique to this work, care settings in which therapy goals are best aligned for restorative devices were found to be outpatient rehabilitation, followed by inpatient rehabilitation. Therapists are the major influencers for adoption because they typically introduce new rehabilitation devices to patients for both clinic and home use. We also learned therapists' utilization rate of a rehabilitation device influences a rehabilitation director's decision to acquire the device for facility use. Main drivers for each stakeholder are identified, along with specific criteria to add details to findings from previous literature. In addition, drivers for home adoption of rehabilitation devices by patients are identified. Rehabilitation device development should consider the best settings to first introduce the device, roles of each stakeholder, and drivers that influence each stakeholder, to accelerate successful adoption of the developed device.

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