Exploration of barriers and enablers for evidence-based interventions for upper limb rehabilitation following a stroke: use of Constraint Induced Movement Therapy and Robot Assisted Therapy in NHS Scotland

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Abstract

The routine use of evidence-based upper limb rehabilitation interventions after stroke has the potential to improve function and increase independence. Two such interventions are Constraint Induced Movement Therapy and Robot Assisted Therapy. Despite evidence to support both interventions, their use within the National Health Service appears, anecdotally, to be low. We sought to understand user perceptions in order to explain low uptake in clinical practice.

Methods
A combination of a cross-sectional online survey with therapists and semi-structured interviews with stroke patients was used to explore uptake and user opinions on the benefits, enablers and barriers to each intervention.

Findings
The therapists surveyed reported low use of Constraint Induced Movement Therapy and Robot Assisted Therapy in clinical practice within the Scottish National Health Service. Barriers identified by therapists were inadequate staffing, and a lack of training and resources. Interviews with stroke patients identified themes that may help us to understand the acceptability of each intervention, such as the impact of motivation.

Conclusion
Barriers to the uptake of Constraint Induced Movement Therapy and Robot Assisted Therapy within the clinical setting were found to be similar. Further qualitative research should be completed in order to help us understand the role patient motivation plays in uptake.
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalBritish Journal of Occupational Therapy
Early online date26 Mar 2020
DOIs
Publication statusE-pub ahead of print - 26 Mar 2020

Keywords

  • stroke
  • upper limb rehabilitation
  • novel techniques
  • barriers
  • benefits
  • enablers
  • occupational therapy

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