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PLoS One. 2016 Dec 19;11(12):e0168311. doi: 10.1371/journal.pone.0168311. eCollection 2016.

Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.

Author information

1
Department of Physical Therapy, Movement Sciences and Rehabilitation, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America.
2
Therapy Department, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada.
3
School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
4
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
5
School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
6
Physiatry, Élisabeth Bruyère Hospital and Bruyère Continuing Care, Ottawa, Ontario, Canada.
7
School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
8
Regional Rehabilitation Center, Hamilton Health Sciences, Hamilton, Ontario, Canada.

Abstract

PURPOSE:

Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use.

METHOD:

A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Self-report and observer-rated outcome measures evaluated therapists' confidence, clinical reasoning and behaviour with respect to MLS use. A focus group captured therapists' perspectives on MLS use during VR-based therapy provision.

RESULTS:

The intervention improved self-reported confidence about MLS use as measured by confidence ratings (p <0.001). Chart-Stimulated Recall indicated a moderate level of competency in therapists' clinical reasoning about MLSs following the intervention, with no changes following additional opportunities to use VR (p = .944). On the Motor Learning Strategy Rating Instrument, no behaviour change with respect to MLS use was noted (p = 0.092). Therapists favoured the strategy of transferring skills from VR to real-life tasks over employing a more comprehensive MLS approach.

CONCLUSION:

The KT intervention improved therapists' confidence but did not have an effect on clinical reasoning or behaviour with regard to MLS use during VR-based therapy.

PMID:
27992492
PMCID:
PMC5167266
DOI:
10.1371/journal.pone.0168311
[Indexed for MEDLINE]
Free PMC Article

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