Using the technology acceptance model to understand clinician barriers and facilitators in using emerging technologies for rehabilitation of the upper limb: A mixed methods study

Dr Marlena Klaic1, Dr Vincent Crocher2, Dr Justin Fong2

1Royal Melbourne Hospital, Parkville, Australia, 2University of Melbourne, Parkville, Australia


It is estimated that up to 85% of stroke survivors have impairment of upper limb function following a stroke. Functional recovery of the paretic upper limb continues to be one of the greatest challenges faced by stroke survivors and their rehabilitation team. Clinical interventions that have the strongest evidence share a common emphasis on task-specific training applied with a higher intensity than usual care. However, there are major barriers associated with the provision of such interventions including limited rehabilitation resources and time constraints. Technological advances in robotics and gaming technology may provide potential solutions to these barriers.

Numerous robotic and gaming devices are now available, and studies have shown that use of these devices can have positive effects. These devices offer a platform for the intensity of practice of upper limb activities that is considered critical for synaptogenesis i.e. neuroplasticity. Despite the growing evidence for using emerging technologies in rehabilitation of the neurologically impaired upper limb, clinical adoption of such devices remains low. Understanding the barriers to implementation of may assist in promoting adoption.

To explain rehabilitation clinicians intention to use emerging technologies in rehabilitation of the neurologically impaired upper limb, using the Extended Technology Acceptance Model (TAM2).

Mixed methods including surveys, focus groups and clinical observations.

18 surveys were completed and 3 focus groups consisting of participants from occupational therapy, physiotherapy and exercise physiology. Clinical observations occurred over a period of 6 weeks in 3 settings, including public and private rehabilitation. Preliminary data analysis suggests that participants believe that emerging technologies can increase work productivity and effectiveness but are too complex to use.

The results from this study can be used to inform implementation strategies aimed at enhancing the uptake of emerging technologies into clinical practice.


Dr Marlena Klaic is the DHHS appointed Allied Health Research & Translation Leader at the Royal Melbourne Hospital. She has 20 years’ experience working clinically in neurological rehabilitation, research and project management. Marlena was a core member of the multidisciplinary team that established the Hand Hub – Australia’s first publicly funded upper limb rehabilitation centre using emerging technologies. She was a co-author on a peer-reviewed paper on the clinical outcomes from the Hand Hub. Marlena completed her PhD on “Enhancing the uptake of evidence-based practice with allied health professionals: A quasi-experimental study”. She is currently involved in a number of multi-site studies related to emerging technologies in rehabilitation of the neurologically impaired upper limb.

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