Introducing robotic upper limb training into routine clinical practice for stroke survivors: Perceptions of occupational therapists and physiotherapists

Journal article


Flynn, Nicholas, Kuys, Suzanne, Froude, Elspeth and Cooke, Deirdre. (2019) Introducing robotic upper limb training into routine clinical practice for stroke survivors: Perceptions of occupational therapists and physiotherapists. Australian Occupational Therapy Journal. 66(4), pp. 530 - 538. https://doi.org/10.1111/1440-1630.12594
AuthorsFlynn, Nicholas, Kuys, Suzanne, Froude, Elspeth and Cooke, Deirdre
Abstract

Introduction: Robot‐assisted therapy for the upper limb (RT‐UL) is an emerging form of intervention for stroke survivors with upper limb deficits. However, there is limited knowledge regarding therapists’ perceptions of RT‐UL and the factors influencing the implementation of RT‐UL into the clinical setting. This is important when considering that therapists in Australia are primarily responsible for the prescription of RT‐UL in daily practice. This study aimed to explore occupational therapists’ and physiotherapists’ perceptions of RT‐UL and the perceived barriers and enablers influencing implementation. Methods: Two discipline‐specific focus groups were conducted involving occupational therapists (n = 6) and physiotherapists (n = 6). Participants were members of the same multidisciplinary team working in an Australian public health rehabilitation facility where RT‐UL (i.e. InMotion2) was being introduced for the first time. Focus groups explored therapist perceptions of the new RT‐UL as well as perceived barriers and enablers to implementation. Focus groups were recorded, transcribed and deductively analysed using the Theoretical Domains Framework (TDF). Results: Out of the 14 domains of the TDF, 7 were raised by participants during the focus groups: environmental context and resources, beliefs about consequences, optimism, knowledge, skills, social influences, and social and professional role and identity. Therapists’ expressed their optimism towards the introduction of RT‐UL but believed successful implementation would be primarily dependent on the availability of clinical leadership, training and a suitable client mix. Conclusion: Therapists perceived that RT‐UL would provide opportunity for increased upper limb practice particularly for patients with severe upper limb impairment. To facilitate implementation, support of RT‐UL should come from both management and clinical leaders and training include RT‐UL efficacy, device functionality and patient suitability. The availability of a single RT‐UL device in a workplace may create unique interdisciplinary and logistical challenges.

Keywordsimplementation; occupational therapy; physical therapy; robotics; stroke rehabilitation; upper extremity
Year2019
JournalAustralian Occupational Therapy Journal
Journal citation66 (4), pp. 530 - 538
PublisherWiley-Blackwell
ISSN0045-0766
Digital Object Identifier (DOI)https://doi.org/10.1111/1440-1630.12594
Scopus EID2-s2.0-85068787001
Page range530 - 538
Research GroupSchool of Allied Health
Place of publicationAustralia
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Lazzarini, Peter A., Ng, Vanessa, Kinnear, Ewan, Kamp, Maarten C., Kuys, Suzanne Shanelle, Hurst, Cameron and Reed, Lloyd. (2014) The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease? Journal of Foot and Ankle Research. 7(1), pp. 1 - 18. https://doi.org/10.1186/1757-1146-7-7
Use and validation of the balance outcome measure for elder rehabilitation in acute care
Kuys, Suzanne, Crouch, Tom, Dolecka, Urszula, Steele, Michael and Low Choy, Nancy. (2014) Use and validation of the balance outcome measure for elder rehabilitation in acute care. New Zealand Journal of Physiotherapy. 42(1), pp. 16 - 21.
Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation
Eng, Xue Wen, Brauer, Sandra, Kuys, Suzanne, Lord, Matthew and Hayward, Kathryn. (2014) Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation. Stroke Research and Treatment. https://doi.org/10.1155/2014/626538
Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation
Eng, Xue Wen, Brauer, Sandra, Kuys, Suzanne Shanelle, Lord, Matthew and Hayward, Kathryn. (2014) Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation. Stroke Research and Treatment. https://doi.org/10.1155/2014/626538
Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA)
Gesch, Janelle, Low Choy, Nancy, Weeks, Benjamin, Passier, Leanne, Nascimento, Margarida, Haines, Terry and Kuys, Suzanne. (2014) Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA). Brain Impairment. 15(2), pp. 132 - 145. https://doi.org/10.1017/BrImp.2014.13
Preparatory teachers' perceptions of school readiness : a survey of Victorian teachers
Imms, Christine, Froude, Elspeth, Joffe, Beverly, Heine, Chyrisse, Merrigan, Celeste and Serry, Tanya. (2014) Preparatory teachers' perceptions of school readiness : a survey of Victorian teachers. The Australian Educational Researcher. 41(1), pp. 109 - 124. https://doi.org/10.1007/s13384-013-0126-8
Activity limitations experienced by people with stroke who received inpatient rehabiliation: Differences between 2001, 2005, and 2011
Kuys, Suzanne Shanelle, Bew, Paul, Lynch, Mary and Brauer, Sandy. (2014) Activity limitations experienced by people with stroke who received inpatient rehabiliation: Differences between 2001, 2005, and 2011. Archives of Physical Medicine and Rehabilitation. 95(4), pp. 741 - 746. https://doi.org/10.1016/j.apmr.2013.12.008
The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation
Tyack, Zephanie, Frakes, Kerrie-Anne, Cornwell, Petrea, Kuys, Suzanne, Barnett, Adrian and McPhail, Steven. (2013) The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation. BMC Health Services Research. 13(410), pp. 1 - 7. https://doi.org/10.1186/1472-6963-13-410
Foundations of the research foundation
Cusick, A., Curtin, M., Froude, Elspeth, Ziviani, Jenny, Stanley, M, Molineux, M and Hoffman, T. (2013) Foundations of the research foundation. Australian Occupational Therapy Journal. 60(6), pp. 377 - 377.
Physiotherapy students find guided journals useful to develop reflective thinking and practice during their first clinical placement : A qualitative study
Constantinou, Maria and Kuys, Suzanne. (2013) Physiotherapy students find guided journals useful to develop reflective thinking and practice during their first clinical placement : A qualitative study. Physiotherapy (print). 99(1), pp. 49 - 55. https://doi.org/10.1016/j.physio.2011.12.002
Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury
Seeto, Treena, Kuys, Suzanne Shanelle, Budden, Cassandra, Griffin, Erin, Kajewski, Haylee and McPhail, Steven. (2013) Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury. Brain Impairment. 14(2), pp. 213 - 221. https://doi.org/10.1017/BrImp.2013.20
Frequency of urinary incontinence in people with chronic heart failure
Hwang, Rita, Chuan, Francine, Peters, Robyn and Kuys, Suzanne. (2013) Frequency of urinary incontinence in people with chronic heart failure. Heart & Lung: the journal of acute and critical care. 42(1), pp. 26 - 31. https://doi.org/10.1016/j.hrtlng.2012.08.003
Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury
Seeto, Treena, Kuys, Suzanne, Budden, Cassandra, Griffin, Erin, Kajewski, Haylee and McPhail, Steven. (2013) Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury. Brain Impairment. 14(2), pp. 213 - 221. https://doi.org/10.1017/BrImp.2013.20
Writing for publication
Froude, Elspeth and Clemson, Lindy. (2013) Writing for publication. Australian Occupational Therapy Journal. 60(4), pp. 229 - 229. https://doi.org/10.1111/1440-1630.12075
Frequency of urinary incontinence in people with chronic heart failure
Hwang, Rita, Chuan, Francine, Peters, Robyn and Kuys, Suzanne Shanelle. (2013) Frequency of urinary incontinence in people with chronic heart failure. Heart & Lung: the journal of acute and critical care. 42(1), pp. 26 - 31. https://doi.org/10.1016/j.hrtlng.2012.08.003
Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury
McClanachan, Nelson, Gesch, Janelle, Wuthapanich, Nampech, Fleming, Jennifer and Kuys, Suzanne Shanelle. (2013) Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury. Brain Injury. 27(12), pp. 1402 - 1408. https://doi.org/10.3109/02699052.2013.823654
Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury
McClanachan, Nelson, Gesch, Janelle, Wuthapanich, Nampech, Fleming, Jennifer and Kuys, Suzanne. (2013) Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury. Brain Injury. 27(12), pp. 1402 - 1408. https://doi.org/10.3109/02699052.2013.823654
What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?
Lazzarini, Peter, O'Rourke, Sharon, Russell, Anthony, Clark, Damien and Kuys, Suzanne Shanelle. (2012) What are the key conditions associated with lower limb amputations in a major Australian teaching hospital? Journal of Foot and Ankle Research. 5(12), pp. 1 - 9. https://doi.org/10.1186/1757-1146-5-12
What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?
Lazzarini, Peter, O'Rourke, Sharon, Russell, Anthony, Clark, Damien and Kuys, Suzanne. (2012) What are the key conditions associated with lower limb amputations in a major Australian teaching hospital? Journal of Foot and Ankle Research. 5(1), pp. 1 - 9. https://doi.org/10.1186/1757-1146-5-12
Prospective study of the participation patterns of Grade 6 and Year 8 students in Victoria, Australia in activities outside of school
McMullan, Sarah, Chin, Rachel, Froude, Elspeth Heather and Imms, Christine. (2012) Prospective study of the participation patterns of Grade 6 and Year 8 students in Victoria, Australia in activities outside of school. Australian Occupational Therapy Journal. 59(3), pp. 197 - 208. https://doi.org/10.1111/j.1440-1630.2012.01013.x
Activity level of hospital medical inpatients: An observational study
Kuys, Suzanne S., Dolecka, Urszula E. and Guard, Amanda. (2012) Activity level of hospital medical inpatients: An observational study. Archives of Gerontology and Geriatrics. 55(2), pp. 417 - 421. https://doi.org/10.1016/j.archger.2012.02.008
Translating evidence into practice: the role of scholarly journals
Froude, Elspeth. (2012) Translating evidence into practice: the role of scholarly journals. Australian Occupational Therapy Journal. 59(3), pp. 171 - 171. https://doi.org/10.1111/j.1440-1630.2012.01021.x
Can Wii work it out?
Cyarto, Elizabeth V., Kuys, Suzanne, Henwood, Tim R. and Blackberry, Irene. (2011) Can Wii work it out? Telecommunications Journal of Australia. 61(3), pp. 37.1 - 37.12.
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial
Kuys, Suzanne S., Brauer, Sandra G. and Ada, Louise. (2011) Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality : A pilot randomized trial
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011) Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality : A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Appropriate seating for medical patients: An audit
Kuys, Suzanne, Dolecka, Urszula and Morrison, Carol. (2011) Appropriate seating for medical patients: An audit. Australian Health Review. 35(3), pp. 316 - 319. https://doi.org/10.1071/AH10943
Changes in falls risk factors for geriatric diagnostic groups across inpatient, outpatient and domiciliary rehabilitation settings
Morrison, Gregory, Lee, Huang-Ling, Kuys, Suzanne, Clarke, Jane, Bew, Paul and Haines, Terry. (2011) Changes in falls risk factors for geriatric diagnostic groups across inpatient, outpatient and domiciliary rehabilitation settings. Disability and Rehabilitation. 33(11), pp. 900 - 907. https://doi.org/10.3109/09638288.2010.514019
Trial of an allied health workload allocation model
Simmons, Nadine and Kuys, Suzanne. (2011) Trial of an allied health workload allocation model. Australian Health Review. 35(2), pp. 168 - 175. https://doi.org/10.1071/AH09860
Leisure Participation Patterns of Children in Victoria Australia
Chin, Rachel, McMullen, Sarah, Froude, Elspeth Heather and Imms, Christine. (2011) Leisure Participation Patterns of Children in Victoria Australia. Australian Occupational Therapy Journal. 58(Suppl s1), pp. 101 - 101. https://doi.org/10.1111/j.1440-1630.2011.00938.x
Factors Influencing Children's Readiness to Enter School :Views From Early Childhood Educators
Froude, Elspeth Heather, Imms, Christine, Merrigan, C, Joffe, Beverly, Heine, Chyrisse and Serry, Tanya. (2011) Factors Influencing Children's Readiness to Enter School :Views From Early Childhood Educators. Australian Occupational Therapy Journal. 58(Suppl s1), pp. 23 - 23.
Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011) Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation. Disability and Rehabilitation. 33(19-20), pp. 1848 - 1853. https://doi.org/10.3109/09638288.2010.549895
Appropriate seating for medical patients: An audit
Kuys, Suzanne S., Dolecka, Urszula E. and Morrison, Carol A.. (2011) Appropriate seating for medical patients: An audit. Australian Health Review. 35(3), pp. 316 - 319. https://doi.org/10.1071/AH10943
Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial
Kuys, Suzanne, Hall, Kathleen, Peasey, Maureen, Wood, Michelle, Cobb, Robyn and Bell, Scott. (2011) Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial. Journal of Physiotherapy. 57(1), pp. 35 - 40. https://doi.org/10.1016/S1836-9553(11)70005-4
Trial of an allied health workload allocation model
Simmons, Nadine and Kuys, Suzanne Shanelle. (2011) Trial of an allied health workload allocation model. Australian Health Review. 35(2), pp. 168 - 175. https://doi.org/10.1071/AH09860
Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke : A multi-centre observational study
Haines, Terry, Kuys, Suzanne, Clarke, Jane, Morrison, Gregory and Bew, Paul. (2011) Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke : A multi-centre observational study. Journal of Evaluation in Clinical Practice. 17(1), pp. 136 - 142. https://doi.org/10.1111/j.1365-2753.2010.01380.x
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011) Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Evaluation of the Australian adaptation of the Keeping It Together (KIT-Australia) information package with carers of children with special needs
Stewart, Janeen, Galvin, Jane, Froude, Elspeth and Lentin, Primrose. (2010) Evaluation of the Australian adaptation of the Keeping It Together (KIT-Australia) information package with carers of children with special needs. Australian Occupational Therapy Journal. 57(4), pp. 268 - 275. https://doi.org/10.1111/j.1440-1630.2010.00858.x
Children's participation in home, school and community life after acquired brain injury
Galvin, Jane, Froude, Elspeth and McAleer, Jennifer. (2010) Children's participation in home, school and community life after acquired brain injury. Australian Occupational Therapy Journal. 57(2), pp. 118 - 126. https://doi.org/10.1111/j.1440-1630.2009.00822.x
Facilitating access to evidence - a benefit to the profession
Froude, Elspeth and Craik, C.. (2010) Facilitating access to evidence - a benefit to the profession. Australian Occupational Therapy Journal. 57(6), pp. 355 - 355.
Writing for the reader
Froude, Elspeth. (2010) Writing for the reader. Australian Occupational Therapy Journal. 57(2), pp. 75 - 75.
Sensory processing abilities of children who have sustained traumatic brain injuries
Galvin, Jane, Froude, Elspeth and Imms, Christine. (2009) Sensory processing abilities of children who have sustained traumatic brain injuries. American Journal of Occupational Therapy. 63(6), pp. 701 - 709. https://doi.org/10.5014/ajot.63.6.701
The relationship between physical performance and self-perception in children with and without cerebral palsy
Ziebell, Melanie, Imms, Christine, Froude, Elspeth, McCoy, Anne and Galea, Mary. (2009) The relationship between physical performance and self-perception in children with and without cerebral palsy. Australian Occupational Therapy Journal. 56(1), pp. 24 - 32. https://doi.org/10.1111/j.1440-1630.2008.00775.x
An investigation of Bilateral Isokinematic Training and Neurodevelopmental Therapy in improving use of the affected hand in children with hemiplegia
Sheppard, Loretta, Mudie, Heather and Froude, Elspeth. (2007) An investigation of Bilateral Isokinematic Training and Neurodevelopmental Therapy in improving use of the affected hand in children with hemiplegia. Physical & Occupational Therapy in Pediatrics. 27(1), pp. 5 - 25.
Therapeutic practice resulted in moderate improvement in handwriting ability for children with poor handwriting when compared with sensorimotor intervention, but not when compared with a control group
Wallen, Margaret and Froude, Elspeth. (2007) Therapeutic practice resulted in moderate improvement in handwriting ability for children with poor handwriting when compared with sensorimotor intervention, but not when compared with a control group. Australian Occupational Therapy Journal. 54(3), pp. 239 - 244.