Fysioterapeutens individualisering i constraint-induced movement therapy. En kvalitativ observasjonsstudie

Formålet med denne studien er å få økt innsikt i hvordan fysioterapeutens individualisering kommer til uttrykk i constraint-induced movement therapy (CIMT)- spesielt rettes søkelyset mot hvordan fysioterapeuten tilpasser treningen i forhold til pasientens bevegelsesproblem i den mest affiserte overekstremitet. Det er valgt å gjøre en kvalitativ observasjonsstudie med ikke-deltakende observasjon. Informantene er strategisk valgt og består av en erfaren fysioterapeut i CIMT og to personer som har gjennomgått hjerneslag 3-9 måneder tidligere. Studiens innsikter peker på at fysioterapeuten har et gjennomgående fokus på bevegelseskvalitet hos pasienten som deltar i CIMT. Tilpasninger foregår i samhandling med pasienten og er rettet mot kroppslige begrensninger, oppgave og miljø. Det foretas endringer som kan understøtte pasientens opplevelse av mening

Patients’ and Health Professionals’ Experiences of Using Virtual Reality Technology for Upper Limb Training after Stroke: A Qualitative Substudy

Background. In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice. Therapy systems employing VR technology can enhance the intensity of training and can also boost patients’ motivation by adding a playful element to therapy. However, reports on user experiences are still scarce. Methods. A qualitative investigation of patients’ and therapists’ perspectives on VR upper limb training. Semistructured face-to-face interviews were conducted with six patients in the final week of the VR intervention. Therapists participated in two focus group interviews after the completion of the intervention. The interviews were analyzed from a phenomenological perspective emphasizing the participants’ perceptions and interpretations. Results. Five key themes were identified from the patients’ perspectives: (i) motivational factors, (ii) engagement, (iii) perceived improvements, (iv) individualization, and (v) device malfunction. The health professionals described the same themes as the patients but less positively, emphasizing negative technical challenges. Conclusion. Patients and therapists mainly valued the intensive and motivational character of VR training. The playful nature of the training appeared to have a significant influence on the patients’ moods and engagement and seemed to promote a “gung-ho” spirit, so they felt that they could perform more repetitions