Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
Phys Ther. 2024 Feb 1;104(2). doi: 10.1093/ptj/pzad140.
Technology-based interventions offer many opportunities to enhance neurorehabilitation, with associated research activity gathering pace. Despite this fact, translation for use in clinical practice has lagged research innovation. An overview of the current "state of play" regarding the extent of clinical uptake and factors that might influence use of technologies is required. This scoping review explored the uptake of technologies as neurorehabilitation interventions in clinical practice and factors that are reported to influence their uptake.
This systematic scoping review was conducted with narrative synthesis and evidence mapping. Studies of any design reporting uptake or implementation of technology (wearable devices, virtual reality, robotics, and exergaming) for movement neurorehabilitation after stroke and other neurological conditions were sought via a formal search strategy in MEDLINE (Ovid), CINAHL, AMED, and Embase. Full-text screening and data extraction were completed independently by 2 reviewers.
Of 609 studies returned, 25 studies were included after title, abstract, and full-text screening. Studies investigated a range of technologies at various stages of development. Only 4 of the included studies explored the sustained use of technology in practice. The following 5 themes representing experiences of technology use emerged: perceived usefulness, technology design, social interaction, integration with services, and suggested improvements to enhance uptake.
Reporting of uptake and use of neurorehabilitation technologies in clinical practice is limited. The synthesis provided comprehensive knowledge of barriers to and facilitators of uptake to be considered in future protocols, including a steep learning curve required to engage with technology, a need for a supportive organizational culture, and a need for user involvement in both design and development.
This scoping review has provided indicators from current evidence of important factors to consider in the planning of research into and clinical implementation of technologies for neurorehabilitation. It serves to support an evidence-based, user-centered platform for improved research on and translation of technologies in neurorehabilitation clinical practice.
基于技术的干预措施为增强神经康复提供了许多机会，相关研究活动也在加速进行。尽管如此，将其翻译为临床实践仍落后于研究创新。需要概述当前技术在临床应用中的采用程度以及可能影响技术采用的因素。本范围综述探讨了技术作为神经康复干预措施在临床实践中的采用情况，以及据报道影响其采用的因素。
本系统范围综述采用叙述性综合和证据绘图进行。通过在 MEDLINE（Ovid）、CINAHL、AMED 和 Embase 中进行正式搜索策略，寻找关于脑卒中及其他神经疾病后运动神经康复的技术（可穿戴设备、虚拟现实、机器人和外骨骼游戏）采用或实施的任何设计研究。两名审查员独立完成了全文筛选和数据提取。
在返回的 609 项研究中，经过标题、摘要和全文筛选，有 25 项研究被纳入。研究调查了各种处于不同开发阶段的技术。只有 4 项纳入研究探讨了技术在实践中的持续使用。出现了以下 5 个主题，代表了技术使用的经验：感知有用性、技术设计、社会互动、与服务的整合以及提高采用率的建议改进。
报告神经康复技术在临床实践中的采用和使用情况有限。综合分析提供了关于采用障碍和促进因素的全面知识，这些因素需要在未来的方案中考虑，包括使用技术所需的陡峭学习曲线、对支持性组织文化的需求以及用户对技术设计和开发的参与需求。
本范围综述提供了当前证据中考虑神经康复技术研究和临床实施的重要因素的指标。它为神经康复临床实践中技术的研究和转化提供了一个基于证据、以用户为中心的平台。
