Perspectives of Japanese physical therapists on the use of virtual reality in stroke rehabilitation: a mixed-methods study.

Abstract

Virtual reality (VR) provides engaging and motivating environments that may enhance motor recovery and patient engagement in stroke rehabilitation. However, clinical adoption remains limited in Japan. This study explored Japanese physical therapists' perspectives on VR use and identified factors influencing adoption. A sequential explanatory mixed-methods design was used. In Phase 1, 141 physical therapists completed a survey adapted from the ADOPT-VR framework. Correlation and multiple regression analyses identified predictors of behavioral intention. In Phase 2, semi-structured interviews with 12 therapists provided in-depth insights, analyzed using thematic analysis. Compatibility (<i>r</i> = .456), perceived usefulness (<i>r</i> = .419), attitude (<i>r</i> = .415), time availability (<i>r</i> = .409), and technical support (<i>r</i> = .405) were moderately correlated with behavioral intention. Regression results indicated that compatibility, technical support, and social norms were significant predictors. Qualitative findings highlighted barriers such as limited training, equipment complexity, and unclear patient selection, while facilitators included peer modeling, hands-on learning, and leadership support. Although attitudes toward VR are positive, adoption is constrained by contextual and organizational barriers. Clinically compatible implementation strategies, targeted training, and institutional support are needed to enhance VR integration in stroke rehabilitation.