Exploring physiotherapists' experiences of implementing robot assisted gait training in a National Health Service inpatient neurorehabilitation setting: a qualitative study.

Abstract

PURPOSE: To explore physiotherapists' experiences of implementing robot assisted gait training (RAGT) in a National Health Service (NHS) inpatient neurorehabilitation setting. Evidence of the efficacy of RAGT is growing, however implementation of this technology into clinical practice is slow. Understanding physiotherapists' experiences can support RAGT integration into neurorehabilitation practice. MATERIALS AND METHODS: A qualitative study using semi-structured online interviews, transcribed and semantically coded using a reflexive thematic analysis approach. The meta-Unified Theory of Acceptance and Use of Technology (UTAUT) model of technology integration informed the data analysis. RESULTS: Nine physiotherapists were purposively sampled, and three main themes were identified from their interviews. A new way of working, relating to physiotherapists' perspectives on how using RAGT altered the therapy experience for patients and for physiotherapists. The nature of exclusivity identified barriers of patient eligibility to use RAGT and perceived inequality between services. Finally, integration presents a challenge identified the steep learning curve required and impact on teamwork, within physiotherapy and in multidisciplinary teams. CONCLUSIONS: The integration of RAGT into NHS clinical practice was reported positively by physiotherapists, offering potential to improve gait rehabilitation for patients. Barriers to successful implementation included time, the degree of learning required, and equity of access.