Developing a Framework for Designing and Deploying Technology-Assisted Rehabilitation After Stroke

Abstract

Objective Many unmet rehabilitation needs of patients with stroke can be addressed effectively using technology. However, technological solutions have not yet been seamlessly incorporated into clinical care. The purpose of this pilot study was to examine how to bridge the gaps between the recovery process, technology, and clinical practice to impact stroke rehabilitation meaningfully. Design Semistructured interviews were performed using a grounded theory approach with purposive sampling of 17 diverse expert providers in acute care, inpatient, and outpatient stroke rehabilitation settings. Common themes were identified from qualitative analyses of the transcribed conversations to develop a guiding framework from the emerging concepts. Results Four core themes emerged that addressed major barriers in stroke rehabilitation and technology-assisted solutions to overcome these barriers: (1) accessibility to quality rehabilitation, (2) adaptability to patient differences, (3) accountability or compliance with rehabilitation, and (4) engagement with rehabilitation. Conclusions The results suggest a four-pronged framework, the A3E framework that stands for Accessibility, Adaptability, Accountability, and Engagement, to comprehensively address existing barriers in providing rehabilitation services. This framework can guide technology developers and clinicians in designing and deploying technology-assisted rehabilitation solutions for poststroke rehabilitation, particularly using telerehabilitation.

Challenges and Barriers Toward Medical Research Among Medical and Dental Students at King Khalid University, Abha, Kingdom of Saudi Arabia

“…Still, many of them expressed little confidence in accessing clinical experience from the trainer and using evidence-based processes. If health professionals have recognized the ability to perform research activities, they are more likely to be involved in medical research (30,31). A recent study conducted in Saudi Arabia shows that the difficulty score decreased significantly with increasing the number of clinical research workshops attended by the researchers (32).…”

Implementation of a Framework for Telerehabilitation in Clinical Care Across the Continuum During COVID-19 and Beyond

“…We used the A3E framework to design, select, and deploy technology to address frequently encountered barriers to accessibility, adaptability, accountability, and engagement. 14 We discuss the lessons learned and the path forward to successfully implement telerehabilitation beyond the COVID-19 pandemic.…”

“…To do this, we adopted a framework that was recently proposed to address barriers to providing rehabilitation using technology, which suggests that technology must enhance Accessibility, Adaptability, Accountability, and Engagement (the A3E framework). 14 This article details how we successfully deployed technology and implemented telerehabilitation across the continuum of care in the context of the A3E framework during the COVID-19 pandemic. We believe that the lessons learned can be useful to rehabilitation providers and administrators to increase access to rehabilitation services more broadly even beyond the pandemic.…”

Experiences of patients who had a stroke and rehabilitation professionals with upper limb rehabilitation robots: a qualitative systematic review protocol

“…Thus, the subjective experiences of rehabilitation professionals with robots become crucial in the selection and use of rehabilitation robots in clinical practice. It is also pertinent to study rehabilitation professionals’ experiences with and attitudes towards using rehabilitation robots in clinical practice since they remain cautious when recommending them 15 16. The literature also acknowledges this need, pointing out that rehabilitation professionals’ attitudes are as important as the benefits derived from robots 15 16.…”

“…It is also pertinent to study rehabilitation professionals’ experiences with and attitudes towards using rehabilitation robots in clinical practice since they remain cautious when recommending them 15 16. The literature also acknowledges this need, pointing out that rehabilitation professionals’ attitudes are as important as the benefits derived from robots 15 16. If upper limb rehabilitation robots are to be successfully incorporated into clinical practice, there is a need for a systematic approach to the adoption of such robots in rehabilitation 15 16.…”