Evaluation of a multi-faceted strategy for implementation of mobility exercises using digital devices within an inpatient rehabilitation setting: phase I of a feasibility hybrid type II implementation-effectiveness randomised controlled trial.

Abstract

Digital devices can be used to deliver mobility exercises in rehabilitation. However, the best way to implement this intervention into practice is unclear. This paper describes the feasibility of delivering strategies to implement digital devices as part of a feasibility hybrid type II implementation-effectiveness trial. Physiotherapists were recruited from a public hospital rehabilitation ward. Training a clinical champion, loaning equipment and changing the gym environment, education and training, facilitation, and audit and feedback strategies were to support implementation. Feasibility outcomes were fidelity and dose of implementation strategies delivered and use of digital devices after receiving implementation strategies, collected from an implementation diary and surveys. Twenty-seven physiotherapists were recruited and received implementation strategies, mostly delivered by the clinical champion. Strategies were delivered as intended (fidelity) but at a higher dosage than anticipated, including 122 h of training (dose). All physiotherapists reported using digital devices with their patients after receiving the implementation strategies. A multi-faceted implementation strategy was feasible to support physiotherapists to use digital devices to train mobility in rehabilitation. The clinical champion played a central role in embedding digital devices into the clinical setting. Australian and New Zealand Clinical Trial Registry; ACTRN12621000938808.