The patients’ experience with neurorehabilitation technologies: A scoping review
Creators: name: Nguyen, Chi
name: Hordacre, Brenton
name: Uy, Jeric
name: Serrada, Ines
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Physiotherapy
subject: Occupational Therapy
subject: Medicine and Health Sciences
subject: Rehabilitation and Therapy

description: Neurological conditions are the leading cause for disability and the second leading cause for death globally (Global Burden of Disease Neurology Collaborators 2019). Due to advances in treatment provision and therapy, survival prospects for patients with neurological disorders have increased (Playford &amp; Nair 2018). Despite these improvements in early medical management, patients often have permanent impairments, resulting in limitations with many occupations, including activities of daily living (ADLs), leisure activities, work, and more (Playford &amp; Nair 2018). As populations are steadily increasing, health service providers globally will face an increasing demand for treatment and rehabilitation services (Carroll 2019). The International Classification of Function Framework is used by the World Health Organisation to define impairment as an abnormality or loss of anatomical, psychological, or physiological function or structure in the human body (World Health Organization 2001). In terms of neurological disorders, common impairments include ataxia, aphasia, involuntary movements, sensory loss, and vision loss (Playford &amp; Nair 2018). Limitations in occupations is defined as restrictions or a lack of ability to occupationally perform an activity within a normal range (Gardner et al. 2017). Impairments therefore lead to limitations in participation in various occupations. The relationship between these three factors, namely neurological impairments, activity limitations, and participation is affected by environmental, personal and occupational factors (Vaughan 2020). As such, neurological rehabilitation is vital as it aims to restore the individual’s functional abilities to the highest level possible (Playford &amp; Nair 2018). Neurorehabilitation technologies, defined as therapeutic technology used to deliver or enhance rehabilitation, are emerging as a novel and engaging approach to provide rehabilitation therapy (Sainburg &amp; Mutha 2016). These technologies are increasingly important for standardised assessments and functional training in rehabilitation and clinical settings (Luft, Bastian &amp; Dietz 2016). Recent research has shown that neurorehabilitation technologies which enables high intensity and repetitive task-specific practice can be more effective than traditional forms of therapy to support rehabilitation and recovery (Molinari et al. 2016). In particular, they open new opportunities for therapy, increase the number of repetitions of movements, increase the duration of training, improve the safety of clients, reduce physical demands on therapists, and are cost effective (Luft, Bastian &amp; Dietz 2016). These technologies can include upper limb robotics, non-invasive brain stimulation, virtual reality, augmented reality, gaming devices, and bodyweight support treadmill training (Cho et al. 2015; Esquenazi et al. 2013; Marin-Pardo et al. 2020; Molinari et al. 2016). A significant benefit of neurorehabilitation technology is that it can provide clients with opportunities to be physically challenged in a safe environment, enabling patients to continually improve function (Brown et al. 2016). While therapists are effective at providing clients with the ‘just right’ challenge, their physical limitations in terms of endurance and strength can reduce their ability to provide consistent challenges to improve the client’s performance (Brown et al. 2016). Technology such as robotics, however, can provide adaptable and challenging exercises in an engaging environment (Brown et al. 2016). This aids the client’s recovery much more effectively by delivering a greater dose of therapy compared to traditional forms of therapy (Brown et al. 2016; Hughes et al. 2016). While neurorehabilitation technologies are a new and modern form of therapy, evidence of their effectiveness and benefits for clients is growing (Bower et al. 2021). An important concept in rehabilitation therapy is client-centred practice (Enemark Larsen, Rasmussen &amp; Christensen 2018). This refers to an active, collaborative partnership with the therapist, an ability to make choices, and an active involvement in decision making processes (Walder &amp; Molineux 2020). Client-centred practice is vital to support a therapeutic process that is suited to each client and more responsive to each individual’s values, needs, and preferences (Enemark Larsen, Rasmussen &amp; Christensen 2018). However, in the past, studies have shown that client-centred practice has not always been implemented in rehabilitation therapy, where the rehabilitation has not fully reflected clients’ needs (Enemark Larsen, Rasmussen &amp; Christensen 2018; Walder &amp; Molineux 2020). Therefore, since neurorehabilitation technologies are a contemporary addition to rehabilitation services, it is vital to start examining ways to optimise client-centred practice in the rehabilitation process. While many studies have explored the efficacy of neurorehabilitation technologies, it remains unclear as to the best approach to assess individual patient experience with these technologies, which creates a gap in the literature. It also represents a gap in client-centred practice regarding neurorehabilitation technologies. There is a lack of understanding of whether individuals enjoy using the technology, whether they find them complex or challenging, or whether they will continue using them in their rehabilitation in the future. Several tools are available but there is currently no summary of those tools or their psychometric properties. Therefore, the primary aim of this study is to identify all available questionnaires that assess the patient’s experience with neurorehabilitation technologies. The secondary aim of this study is to obtain the psychometric data of the questionnaires where possible. With increasing use of neurorehabilitation technologies and the continued development of new technology-based therapies, it will be beneficial to have a comprehensive summary of questionnaires and their psychometric data. This will help clinicians make informed decisions as to how to assess their patients’ experiences with the type of technology being used. This list could also provide the starting steps for implementation of client-centred practice within the contemporary neurorehabilitation technology setting. It is anticipated that this review could prove useful for clinicians and researchers seeking to understand the patient experience with neurorehabilitation technologies.