Olsen Sharon, Lim Xiao Min Lilian, Alder Gemma, Stavric Verna, Signal Nada
Rehabilitation Innovation Centre, Auckland University of Technology, Auckland, New Zealand.
Occupational Therapy, Jurong Community Hospital, Singapore, Singapore.
Disabil Rehabil Assist Technol. 2025 May;20(4):804-822. doi: 10.1080/17483107.2024.2435571. Epub 2024 Dec 13.
Rehabilitation technology (RT) development has grown, however evidence suggests poor uptake by therapists and patients, with many devices abandoned. Successful implementation encompasses both "adoption," where RT is first utilized, and "sustained use," wherein RT remains in use over time. This scoping review and qualitative analysis aimed to explore the extent and nature of the relevant evidence base and investigate factors that influence adoption and sustained use of RT in clinical practice, from the perspectives of patients and therapists.
A systematic search was conducted to identify qualitative and quantitative articles investigating adoption and/or sustained use of RT. Study characteristics were analyzed quantitatively. Factors influencing adoption and sustained use were analyzed using a two-stage thematic analysis. Stage 1 employed an inductive approach, analyzing data related to RT adoption from review papers. Stage 2 employed an abductive approach, where data related to sustained use from primary research and reviews was mapped to Stage 1 themes and new themes were identified.
The review included 42 articles. The majority of articles explored RT adoption. Thematic analysis revealed five themes. Four influenced adoption of RT: (1) "Knowledge" about RT; (2) "Design" of RT; (3) "Circumstances and Characteristics;" and, (4) the "Person-centered" approach. These were confirmed and refined in the sustained use analysis, and a fifth theme, "Healthcare Ecosystem," was identified.
These findings highlight factors influencing adoption and sustained use of RT, providing insights for development and implementation of technology in rehabilitation clinical practice. Further research is needed to identify strategies that facilitate sustained use of RT.
康复技术（RT）不断发展，然而有证据表明治疗师和患者对其采用率较低，许多设备被弃用。成功实施包括“采用”（首次使用RT）和“持续使用”（RT随着时间推移仍在使用）。本综述性研究和定性分析旨在从患者和治疗师的角度，探讨相关证据基础的范围和性质，并调查影响RT在临床实践中采用和持续使用的因素。
进行系统检索，以识别调查RT采用和/或持续使用情况的定性和定量文章。对研究特征进行定量分析。采用两阶段主题分析法分析影响采用和持续使用的因素。第一阶段采用归纳法，分析综述论文中与RT采用相关的数据。第二阶段采用溯因法，将来自原始研究和综述中与持续使用相关的数据映射到第一阶段的主题，并确定新主题。
该综述纳入42篇文章。大多数文章探讨了RT的采用情况。主题分析揭示了五个主题。四个主题影响RT的采用：（1）关于RT的“知识”；（2）RT的“设计”；（3）“情况和特征”；以及（4）“以人为本”的方法。这些在持续使用分析中得到确认和完善，并确定了第五个主题“医疗保健生态系统”。
这些发现突出了影响RT采用和持续使用的因素，为康复临床实践中技术的开发和实施提供了见解。需要进一步研究以确定促进RT持续使用的策略。
