An exploration of stakeholders’ perceptions of the barriers to clinical use of Assistive Technologies in services for upper-limb stroke rehabilitation

Abstract

Introduction Half of all patients commencing stroke rehabilitation have marked impairment of the hemiplegic arm, with only 14% regaining useful function. Assistive technologies (ATs) have been developed and evaluated yet currently reach only a fraction of patients. The NIHR funded a five year research programme to generate understanding necessary to develop cost-effective stroke services in upper-limb rehabilitation. This stage aims to understand the potential advantages and disadvantages to the clinical use of ATs, and the needs and priorities of stakeholders. Method Participants include people with a stroke (n=40), their carers (n=20), health care professionals (n= 40), budget holders (n=15) and service commissioners (n=15). An interactive exhibition was held at the University of Southampton in October 2009 where stakeholders tested a range of ATs. Focus groups with each stakeholder group will be conducted within three months of the exhibition to discuss personal involvement in AT use, and positive and negative views on the AT presented. Results Results will be categorised in terms of barriers and facilitators to the use of upper-limb technologies addressing issues such as user comfort and acceptability, cost-benefit, evidence of effect and funding provision. Conclusion Getting research implemented in practice is challenging. This novel approach explores the barriers to using new technologies from the perspective of all key stakeholders. These findings will be combined with those of a national survey, and systematic review to inform a clinical trial resulting in a recommended care pathway for upper-limb rehabilitation